Premedication: Premedication should be selected according to the need of the individual patient and at the discretion of the anesthesiologist.
Surgical Anesthesia: The concentration of sevoflurane being delivered from a vaporizer during anesthesia should be known. This may be accomplished by using a vaporizer calibrated specifically for sevoflurane.
Induction: Dosage should be individualized and titrated to the desired effect according to the patient's age and clinical status. A short-acting barbiturate or other IV induction agent may be administered followed by inhalation of sevoflurane. Induction with sevoflurane may be achieved in oxygen or in combination with oxygen-nitrous oxide mixtures. For induction of anesthesia, inspired concentrations of up to 8% sevoflurane usually produces surgical anesthesia in <2 min in both adults and children.
Maintenance: Surgical levels of anesthesia may be sustained with concentrations of 0.5-3% sevoflurane with or without the concomitant use of nitrous oxide (see Nitrous Oxide under Interactions). (See Table 3.)
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Emergence: Emergence times are generally short following sevoflurane anesthesia. Therefore, patients may require postoperative pain relief earlier.
Elderly: Minimum alveolar concentration decreases with increasing age. The average concentration of sevoflurane to achieve MAC in an 80 years of age is approximately 50% of that required in a 20 years of age.