Flourinated Anesthetics – Compilation

FLOURINATED ANESTHETICS – COMPILATION


IMPORTANT POINTS ON FLUORINATED ANESTHETICS:

1. Desflurane:

  • Newer all fluorinated congener of isoflurane.
  • Greenhouse gas causing maximum global warming.
  • Mainly for outpatient surgery.
  • Fastest-acting inhalation anesthetic with minimum blood: gas partition coefficient (0.42).
  • Pungent odor.
  • Highly volatile.
    • Thermostatically heated special vaporizer used for delivering precise concentration of pure desflurane vapor in carrier gas (N2O + O2) mixture.
  • Metabolically stable, only 0.2% metabolized.

Actions & Uses:

  • Less potent than isoflurane.
  • Safe anesthetic for geriatric patients.
  • CVS effects similar to isoflurane without coronary steal.
    • Causes mild myocardial depression.
    • Lesser than enflurane/halothane.
  • Do not provoke seizures, arrhythmia, no liver & kidney toxicity.

Adverse effect:

  • Coughing & laryngospasm – Pungent odour – Unsuitable for induction.

2. Enflurane: 

  • Faster acting halothane substitute.
  • Halogenated ether.
  • Causes maximum respiratory depression.
  • Contraindicated in epilepsy – Maximum propensity provoking seizures.

3. Methoxyflurane:

  • Most potent inhalation agent (least MAC).
  • Not used now. (Halothane – Most potent).
  • Slowest onset & recovery.
  • Should not be used in closed circuit – Reacts with rubber tubing.
  • Boiling point more than water (104°C).

Metabolism:

  • Intrarenal metabolism → Fluoride ion production.
  • Causes renal toxicity (high output renal failure & hepatotoxicity). 

Exam Important

  • Desflurane is greenhouse gas causing maximum global warming.
  • Desflurane is mainly for outpatient surgery.
  • Desflurane is fastest-acting inhalation anesthetic with minimum blood: gas partition coefficient (0.42).
  • Desflurane is of pungent odor, highly volatile, metabolically stable, only 0.2% metabolized.
  • Safe anesthetic for geriatric patients is desflurane.
  • Desflurane has CVS effects similar to isoflurane without coronary steal.
  • Desflurane causes mild myocardial depression but l 
  • Enflurane contraindicated in epilepsy with maximum propensity provoking seizures.
  • Methoxyflurane is the most potent inhalation agent (least MAC).
  • Methoxyflurane should not be used in closed circuit reacts with rubber tubing.
  • Methoxyflurane boiling point more than water (104°C).
  • Intrarenal metabolism of methoxyflurane produces fluoride ions causing high output renal failure & hepatotoxicity. 
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