Adult Dosing
Anesthesia
Induction of surgical anesthesia
- 1.5-3% along with O2 or O2 and N2O mixture, produces anesthesia in 7-10 minutes
Maintenance of surgical anesthesia
- 1-2.5% along with N2O; an additional 0.5-1% required if given with O2 alone
Notes:- Calculate the concentration of isoflurane delivered using vaporizers calibrated specifically for isoflurane
- Select appropriate premedication as per requirement of the individual patient
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Isoflurane may cause malignant hyperthermia in susceptible patients manifested by muscle rigidity, tachycardia, tachypnea, cyanosis, arrhythmias, and unstable blood pressure. If such symptoms are observed, promptly discontinue the drug and initiate appropriate treatment
- Deeper levels of anesthesia may result in hypotension, respiratory depression and a transient increase in CSF pressure
- Use of isoflurane in pediatric patients may cause perioperative hyperkalemia resulting in cardiac arrhythmias and death during the postoperative period. Patients with latent or overt neuromuscular disease, particularly Duchenne muscular dystrophy, are more prone to develop perioperative hyperkalemia
- Isoflurane can react with desiccated CO2 absorbents to produce carbon monoxide, thereby increasing the levels of carboxyhemoglobin in certain patients
- Isoflurane may cause sensitivity hepatitis in patients previously sensitized by exposure to halogenated anesthetics
- Isoflurane should be administered in an adequately equipped setting by medical personnel qualified and experienced in managing anesthetized patients
- Maintain normal hemodynamics in patients with coronary heart disease to avoid the risk of myocardial ischemia
- Isoflurane may cause transient increases in BSP retention, blood glucose, and serum creatinine with decreases in BUN, serum cholesterol, and alkaline phosphatase
- May cause a slight decrease in intellectual functions and small mood changes which may last for a few days post therapy
Cautions: Use cautiously in
Supplemental Patient Information
- Advise patients about the possible decrease in intellectual functions and mood changes which may last for a few days post therapy
Pregnancy Category:C
Breastfeeding: Safety unknown. Breastfeeding can be resumed soon after the mother has recovered sufficiently from general anesthesia, as the serum half-life of isoflurane in the mother is short and the drug is not expected to be absorbed by the breastfed infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 14 June 2011). Manufacturer advises caution.
