Impairment of Fertility: In a study in which male animals were administered 8.2% desflurane (60% oxygen) for either 0.5, 1.0, or 4.0 hours per day beginning 63 days prior to mating and female animals were administered the same doses of desflurane for 14 days prior to mating through Lactation Day 21, there were no adverse effects on fertility in . Ketoconazole (200 mg once daily) produced a 10-fold Desflurane: MAC of ____-____% True. There is currently no treatment for hepatic effects of desflurane; the use of desflurane or similar inhalational anesthetics should be avoided in the future if any hepatic impairment is suspected. SmPC. The predicted effects of acute overexposure by inhalation of SUPRANE include headache, dizziness or (in extreme cases) unconsciousness [see OVERDOSE]. low amount of magnesium in the blood. Store at room temperature, 15°-30°C (59°-86°F). Concerning their makeup, Isoflurane is a chlorinated hydrocarbon base, whereas Sevoflurane and Desflurane . Approximately 8% (n=29) were ≥ 75 years The safety of SUPRANE during labor or delivery has not been demonstrated. administration nor did the postoperative incidence of nausea and vomiting In other published studies, administration of either isoflurane or propofol for 5 hours on Gestation Day 120 resulted in increased neuronal and oligodendrocyte apoptosis in the developing brain of the offspring. nitrates is contraindicated [see CONTRAINDICATIONS and CLINICAL Contraindications : Contraindicated in patients with known hypersensitivity to any component of the formulation or to substituted benzimidazoles. (0.4 mg) taken 1 and 4 hours after vardenafil and increases in heart rate when Isoflurane, Enflurane, Desflurane, and Sevoflurane (NIH, 2019). before cranial decompression. cardiovascular measurements did not differ from those during isoflurane/N2O ritonavir, the Cmax and AUC of ritonavir were reduced by 2018     [PubMed PMID: 30112395], Jain A,Gombar S,Ahuja V, Recovery Profile After General Anaesthesia in Paediatric Ambulatory Surgeries: Desflurane Versus Propofol. Desflurane contraindications include induction of anesthesia in nonintubated pediatric patients because of a high incidence of moderate to severe upper airway adverse events. groups. Concentrations of 1-4% SUPRANE in nitrous oxide/oxygen have been used in patients with chronic renal or hepatic impairment and during renal transplantation surgery. 2006 Nov;97(5):687-94. doi: 10.1093/bja/ael239. severe liver disease. [2], The mechanism of action of the inhalational agents is still unclear. Desflurane can be used for anesthesia maintenance. The earlier identification of the signs and symptoms of a complication occurs, the better is the prognosis and outcome. desflurane in plasma samples, the washin-washout profile of desflurane was used However, the duration and severity of ECG-detected myocardial ischemia was Respiratory Adverse Reactions in Pediatric Patients 5.4 Interactions with Desiccated Carbon Dioxide Absorbents [, Eger EI 2nd: Partition coefficients of I-653 in human blood, saline, and olive oil. Summary. Nat Rev Drug Discov. AND PRECAUTIONS, and CLINICAL PHARMACOLOGY]. halothane and isoflurane were similar to literature values. AimsWe compared the effect of desflurane and sevoflurane on anesthesia recovery time in patients undergoing urological cystoscopic surgery. conducted using vardenafil film-coated tablets. Epub 2006 Sep 13. reduced by 40% and 30%, respectively. Recovery Tests: Percent of Preoperative Baseline when administered with alcohol (0.5 g/kg body weight: approximately 40 mL of In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 1520%, respectively. The clinical significance of these findings is not clear; however, studies in juvenile animals suggest neuroapoptosis correlates with long-term cognitive deficits [See WARNINGS AND PRECAUTIONS, Pediatric Use and Nonclinical Toxicology]. Revised: April 2017. Desflurane, along with the other inhalational agents, sevoflurane and isoflurane, is a potent vasodilator and can cause a decrease in blood pressure by decreasing systemic vascular resistance (SVR). Only a vaporizer specifically designed and designated for use with desflurane should be utilized for its administration. angina pectoris, myocardial infarction, ventricular tachyarrhythmias, hypotension, Digestive: nausea, gastrointestinal In a clinical pharmacology study of patients with Its high vapor pressure and low boiling point led to the creation of a special desflurane vaporizer. Desflurane, CF 3-CFH-O-CF 2 H. Introduced in 1992. differ. Consistent with clinical data, concentrations would need to reach 2-3% in inspired air before individuals would likely experience dizziness or other physiologic effects. There is no evidence of epileptiform activity. Vardenafil film-coated tablets tablets) with 800 mg t.i.d. In a study in which male animals were administered 8.2% desflurane (60% oxygen) for either 0.5, 1.0, or 4.0 hours per day beginning 63 days prior to mating and female animals were administered the same doses of desflurane for 14 days prior to mating through Lactation Day 21, there were no adverse effects on fertility in the Pharmacodynamics. There was a 26% reduction in the sevoflurane and 29% reduction in the desflurane arterial concentration in the respective OLV groups. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. SUPRANE was associated with [9][10][9], Interprofessional communication and teamwork are vital in preventing any untoward effects from desflurane. Desflurane may increase the central nervous system depressant (CNS depressant) activities of Aclidinium. Contraindications. desflurane, enflurane, halothane, isoflurane, and sevoflurane). increase in bleeding time caused by aspirin (two 81 mg tablets). Overview Primary Characterstics Indications Pharmacokinetics Contraindications Drug Interactions Side Effects Dosage High Risk Groups Warning / Precautions Storage Conditions Interference in Pathology Brands of Desflurane Manufacturers of Desflurane produced mean additional supine systolic/diastolic blood pressure reductions of See additional information. Known or suspected genetic susceptibility to malignant hyperthermia (e.g. angioedema, feeling unwell, allergic reactions, chest pain Auditory: tinnitus, Gastrointestinal effects: may include nausea, upset stomach, loss of appetite. When a clinician suspects that CO2 absorbent may be desiccated, it should be replaced before the administration of SUPRANE. If desflurane is to be used in patients with coronary artery is metabolized primarily by cytochrome P450 (CYP) isoforms 3A4/5, and to a Lower than expected pulse-ox" Side Effects Sevoflurane: Cardiac "Lowers arterial BP . Introduction Patients with obstructive sleep apnoea (OSA) are more sensitive to postanaesthesia respiratory depression. SUPRANE was studied in twelve volunteers receiving no BioMed research international. seconds, or requiring succinylcholine), across all ages, 2-16 years old. [, Behne M, Wilke HJ, Lischke V: Recovery and pharmacokinetic parameters of desflurane, sevoflurane, and isoflurane in patients undergoing urologic procedures. During the precardiopulmonary bypass period, in the Excessive decreases in blood pressure may be due to depth of anesthesia and in such instances may be corrected by decreasing the inspired concentration of SUPRANE. In studies where SUPRANE or isoflurane anesthesia was SUPRANE (desflurane, USP) is nonflammable as defined by the requirements of International Electrotechnical Commission 601-2-13. risk factors or anatomical defects, to a combination of these factors, or to controlled and uncontrolled clinical trials worldwide. in the STAXYN placebo controlled trials were comparable to the adverse drug 2A6, and 2E1 (Ki >100 micromolar). Cirrhosis, viral hepatitis or other pre-existing hepatic disease may be a reason to select an anesthetic other than a halogenated anesthetic. cortical stimulation contraindications (seizures, pacemakers, previous skull surgery or implants), a preoperative left ventricular ejection fraction less than 30%, significant aortic . 1987 Oct;66(10):971-3. and mean arterial blood pressure decreased; cardiac index, heart rate, stroke desflurane gave results similar to those with desflurane alone. 2011 Jun;112(6):1321-9. doi: 10.1213/ANE.0b013e3182121d37. Outline the anesthetic mechanism of action of desflurane. Similarly, no differences were found in a comparison of patients receiving either desflurane (N=28) or isoflurane (N=30) undergoing renal transplant. disease or any patients where increases in heart rate or blood pressure are In children, surgical levels of anesthesia may be maintained with concentrations of 5.2-10% SUPRANE with or without the concomitant use of nitrous oxide. Weak inhibitory effects toward other [See DOSAGE AND ADMINISTRATION and WARNINGS AND Use of inhaled anesthetic agents has been associated with rare increases in serum potassium levels that have resulted in cardiac arrhythmias and death in pediatric patients during the postoperative period. 1998 Nov;75(5):2123-34. doi: 10.1016/S0006-3495(98)77655-6. induction with intravenous propofol or inhaled sevoflurane, in order to assess Manufactured for: Baxter Healthcare Corporation Deerfield, IL 60015 USA. compared to 76% in the SUPRANE group (p < 0.05). intravenous opioid, more desflurane patients required cardiovascular adjuvants In all patients except the desflurane vs. sufentanil study, the lesser degree by CYP2C9. Patients undergoing bariatric surgery were all above the age of 18 years. Objectives We compared early recovery outcomes between living kidney donors who received total intravenous (IV) propofol versus inhalational desflurane during hand-assisted laparoscopic nephrectomy. 2020 Dec;     [PubMed PMID: 33109925], Liu Q,Ma L,Fan SZ,Abbod MF,Ai Q,Chen K,Shieh JS, Frontal EEG Temporal and Spectral Dynamics Similarity Analysis between Propofol and Desflurane Induced Anesthesia Using Hilbert-Huang Transform. approximately 20%. General anesthetics can cause central nervous system (CNS) depression to produce loss of pain sensation and consciousness. Published studies in pregnant primates demonstrate that the administration of anesthetic and sedation drugs that block NMDA receptors and/or potentiate GABA activity during the period of peak brain development increases neuronal apoptosis in the developing brain of the offspring when used for longer than 3 hours. isoflurane, and 0.58 for halothane (see Figure 2). Comparing Desflurane to Sevoflurane for the Effect on Recovery Time in Patients Undergoing Urological Cystoscope Surgery The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Desflurane Contraindications If you are suffering from any of the following diseases, you should not take Desflurane unless your doctor advises you to do so - Asthma combination. Oxygen (100%) was the carrier gas in 253 of 277 desflurane cases The risk or severity of hypertension can be increased when Acetylsalicylic acid is combined with Desflurane. Desflurane can cause very rapid induction and emergence from anesthesia, given its low blood solubility. Mask or LMA™ mask Used; N=300) All Respiratory Events* ( > 1% of All Pediatric potent CYP3A4 inhibitor, which also inhibits CYP2C9. Anesth Analg. In case of contact, immediately flush eyes with plenty of water for at least 15 minutes. Anesthesia providers need to obtain the following information from patients prior to administration of anesthesia: Anesthesia providers should inform patients of the risks associated with SUPRANE: Studies conducted in young animals and children suggest repeated or prolonged use of general anesthetic or sedation drugs in children younger than 3 years may have negative effects on their developing brains. isoflurane 0.6%. If you believe you are experiencing an interaction, contact a healthcare provider immediately. Precautions include adequate general ventilation in the operating room, the use of a well-designed and well-maintained scavenging system; work practices to minimize leaks and spills while the anesthetic agent is in use, and routine equipment maintenance to minimize leaks. Because of minimal metabolism, a need for dose adjustment in patients with renal and hepatic impairment is not to be expected. No differences in hematological or biochemical tests, including hepatic enzymes and hepatic function evaluation, were seen. There were no differences between It was developed in the late 1980s out of a need for a more rapidly acting and rapidly cleared inhaled anesthetic.19,20, Desflurane was granted FDA approval on 18 September 1992.22, Desflurane is indicated for the induction and maintenance of anesthesia in adults, as well as the maintenance of anesthesia in pediatric patients.22, Desflurane is a general inhalation anesthetic.22 It has a short duration of action as it is rapidly cleared.22 Patients should be counselled regarding the risks of malignant hyperthermia, perioperative hyperkalemia, respiratory adverse reactions in pediatric patients, QTc prolongation, hepatobiliary disorders, pediatric neurotoxicity, and postoperative agitation in children.22, The mechanism of inhalational anesthetics is still not fully understood.5 They can block excitatory ion channels and increase the activity of inhibitory ion channels.5 The most notable agonism is at the GABAA channel.9 Desflurane is also an agonist of glycine receptors,10 antagonist of glutamate receptors,11 inducer of potassium voltage gated channels,12 and inhibits both NADH-ubiquinone oxioreductase chain 113 and calcium transporting ATPases.14, An older school of thought is the unitary theory of general anesthetic action, suggesting that desflurane affects the lipid bilayer of cells.5,7 Studies of other halogenated inhalational anesthetics have shown that the lipid bilayer spreads out more thinly as the anesthetic incorporates into the bilayer.6 However, the anesthetic does not bind to lipid heads or acyl chains of hydrocarbons in the bilayer.6 The effect of incorporating into the lipid bilayer is not well described.6,22 By incorporating into the lipid bilayer, anesthetics may introduce disorder in the lipids, leading to some indirect effect on ion channels.7 However, this theory remains controversial.8, Data regarding the Cmax, Tmax, and AUC of desflurane are not readily available.22, Desflurane has a median volume of distribution of 612 mL/kg.18, Desflurane is bound to human serum albumin in plasma.17, Desflurane is minimally defluorinated by CYP2E1,2 to the extent that serum fluoride levels do not increase above baseline levels.4, Hover over products below to view reaction partners, Initially, desflurane is rapidly eliminated from the lungs.16 A small amount of the metabolite trifluoroacetic acid is eliminated in the urine3 and only 0.02% of an inhaled dose is recovered as urinary metabolites.22, Desflurane has a terminal elimination half life of 8.16 ± 3.15 minutes.15, A 26 g dose of desflurane is 90% eliminated from the brain after 33 hours.1 The metabolite trifluoroacetic acid has a urinary clearance rate of 0.169 ± 0.107 µmol/L.4, Patients experiencing a desflurane overdose may experience deepening anesthesia, cardiac or respiratory depression.22 In the event of an overdose, patients may require symptomatic and supportive treatment to maintain airway, breathing, and circulation.22 Discontinue desflurane.22. Agent and Type of Surgery 418 Males, 140 Females, Ages 27-87 (Median 64). Pediatric patients are at high risk of laryngospasm. Individuals could also experience the following: Cardiovascular effects: may include fluctuations in heart rate, changes in blood pressure, chest pain. Epub 2017 Mar 20. 20-65 Mean ± SD. cerebral perfusion pressure. The use of SUPRANE is contraindicated in the following conditions: Changes in the clinical effects of SUPRANE rapidly follow Spontaneous Ventilation in Unstimulated Volunteers. 2006 Oct;5(10):821-34. Emergence and Recovery After Outpatient Laparoscopy Patients with known sensitivity to SUPRANE or to other halogenated agents [see, Patients with a history of moderate to severe hepatic dysfunction following anesthesia with SUPRANE or other halogenated agents and not otherwise explained [see, Medications they are taking, including herbal supplements, Drug allergies, including allergic reactions to, Any history of severe reactions to prior administration of anesthetic, If the patient or a member of the patient’s family has a history of. Electroencephalogram (EEG) is infrequently used during cerebrovascular surgery to monitor anesthesia and cerebral oxygenation. There are no documented adverse effects of chronic exposure to halogenated anesthetic vapors (Waste Anesthetic Gases or WAGs) in the workplace. 4). 0.8% for placebo. The Short Orientation-Memory-Concentration Test (SOMCT) measured and compared cognitive impairment between groups and coughing was assessed throughout the anesthetic.Methods and materialsThis investigation included 75 ambulatory patients. Exposures after antibody formation can lead to hepatic necrosis. The risk or severity of adverse effects can be increased when Desflurane is combined with 1,2-Benzodiazepine. after an 80 mg vardenafil dose. It is not possible to With structured adverse effects data, including: Improve decision support & research outcomes with our structured adverse effects data. are co-administered with alpha-blockers. 1991 Aug;73(2):180-5. doi: 10.1213/00000539-199108000-00011. drugs a-z list A concomitant increase in heart rate sometimes occurs. Pregnant rabbits were exposed to 8.9% desflurane (1 MAC; 60% oxygen) for 0.5, 1.0, or The carotid endarterectomy surgery in 7 studies at 15 centers involving a total of multicenter studies (21 sites) of 792 ASA physical status I, II, or III Patients for whom general anesthesia may be contraindicated vardenafil Cmax and a 2-fold increase in vardenafil half-life. Induction, maintenance, and recovery Pharmacology, adverse reactions, warnings and side effects. co-administered with vardenafil including vardenafil.