Adult Dosing

Induction of anesthesia

• Individualize dosage; 2-4.5% produces surgical anesthesia x7-10min

Maintenance of anesthesia

• 0.5-3%; Max: 3%

Obstetrical analgesia

• 0.25-1% for vaginal delivery or as supplement anesthesia for Cesarean Section; higher concentration may cause uterine relaxation, bleeding

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

• Hypersensitivity to any of the ingredients of the product
• Malignant hyperthermia history or genetic susceptibility
• History of seizure disorder

• Hypersensitivity to any of the ingredients of the product
• Malignant hyperthermia
• History of seizure disorder

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined, adjustment may be necessary to avoid hepatotoxicity

• Therapy may cause malignant hyperthermia in susceptible patients. Immediately suspend therapy if incidences of malignant hyperthermia occur
• Desflurane has been associated with perioperative hyperkalemia resulted in cardiac arrhythmias and death in pediatric patients. The risk is increased in patients with latent or overt neuromuscular disease, particularly with Duchenne muscular dystrophy
• In patients sensitized by previous exposure to halogenated anesthetics therapy may cause sensitivity hepatitis
• As therapy is associated with high incidences of moderate to severe respiratory adverse reactions, including coughing, laryngospasm and secretions, it is not indicated in children as an anesthesia induction agent or for maintenance of anesthesia in non-intubated children
• Therapy may result in elevated levels of carboxyhemoglobin in some patients as desflurane can react with desiccated carbon dioxide (CO2) absorbents to produce carbon monoxide
• Transient elevations in glucose and white blood cell count may occur
• Administration with CO(2) absorbents, desiccated may form carbon monoxide with potential increases in carboxyhemoblobin levels

Cautions: Use cautiously in

• Increased ICP
• CAD
• HTN
• Tachycardia
• Neuromuscular disorder
• Muscular dystrophy
• Perioperative hyperkalemia

Pregnancy Category:B

Breastfeeding: Safety unknown. Breastfeeding can be resumed as soon as the mother has recovered sufficiently from general anesthesia to nurse because the serum half-life of enflurane in the mother is short and the drug is not expected to be absorbed by the infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 24 May 2011). Due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of drug, taking into account the importance of the drug to the mother.

• CNS: Headache, malignant hyperthermia, nervousness, involuntary movement
• CV: Bradycardia, hypertension, nodal arrhythmia, tachycardia, myocardial ischemia
• GI: Nausea, vomiting, increased salivation, hepatotoxicity
• RESP: Cough, breathholding, apnea, laryngospasm, oxyhemoglobin desaturation, respiratory depression, bronchospasm
• EENT: Pharyngitis, laryngospasm, conjunctivitis
• METABOLIC: Severe hyperkalemia

• General anesthetic; exact mechanism of action unknown
• Minimally metabolized by liver
• Primarily excreted unchanged in lungs; urine
• Half-life: Unknown

US Trade Name(s)

• Ethrane

US Availability

enflurane (generic)

• LIQ: 99.9%

Ethrane

• LIQ: 99.9%

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Anesthesia

General Anesthetics, Inhalation