Inhalation agent for anesth for inpatient & outpatient surgery: Induction of anesth in adult. Contraindicated for induction in ped patients. Maintenance of anesth in adults & in ped patients.
Administer by inhalation using specific vaporiser. Administration must be individualized based on patient’s response. For age of 70 yr, the MAC (end-tidal%) is 5.2±0.6% w/ 100% oxygen, & 1.7±0.4% w/ 60% N2O/40% oxygen. Adult Pre-medicated w/ opioid. Frequent starting conc is 3% & increased in 0.5-1% increments every 2-3 breaths. After induction w/ IV drug start at 0.5-1 MAC in O2 or N2O/O2. Maintain w/ conc of 2.5-8.5% w/ or w/o concomitant N2O. Childn Maintain w/ conc of 5.2-10% w/ or w/o concomitant N2O.
View Suprane overdosage for action to be taken in the event of an overdose.
Contraindications
Known sensitivity to Suprane or halogenated agents; known or suspected genetic susceptibility to malignant hyperthermia. Patients in whom general anesth is contraindicated. Induction of anesth in ped patient. Patients w/ history of moderate to severe hepatic dysfunction following anesth w/ Suprane or other halogenated agents & not otherwise explained.
In patients w/ intracranial space occupying lesions, administer at 0.8 MAC or less, & in conjunction w/ a barbiturate induction & hyperventilation (hypocapnia). Appropriate measures should be taken to maintain cerebral perfusion pressure. Malignant hyperthermia may be triggered. Inhaled anaesthetics have been associated w/ rare increases in serum K. Early & aggressive intervention to treat hyperkalemia & resistant arrhythmias is recommended. Childn <6 yr who are under anesthetic maintenance w/ Suprane via LMA should be closely monitored for signs & symptoms associated w/ laryngospasm. Childn w/ asthma or history of recent upper airway infection should be closely monitored for signs & symptoms associated w/ airway narrowing. Carbon dioxide absorbers should not dry out. Disruption of hepatic function, icterus & fatal liver necrosis have been reported w/ halogenated anaesthetics. Transient elevations in glucose & WBC count may occur. Pregnancy. Not indicated during lactation.
Benzodiazepines & opioids decreased the MAC of desflurane. Anesth conc of desflurane reduced the ED95 of succinylcholine by approx 30% & that of atracurium & pancuronium by approx
50% compared to N2O/opioid. Concomitant use w/ N2O reduces the MAC of desflurane.
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