Sevoflurane Flashcards
Sevoflurane Pulmonary Effects
- respiratory depression with very slight tachypnea
- decreased VT causes minute ventilation and CO2 retention
- bronchodilation
- inhibits bronchoconstriction
- least airway irritant of all inhalation agents
- great for induction inhalation
Sevoflurane Physical Property: boiling
58.5 C
Sevoflurane Physical Property: SVP
157 mmHg
Sevoflurane Physical Property: MAC
2%
Sevoflurane Physical Property: Blood/Gas Coefficient
0.69
Sevoflurane Physical Property: Brain/Blood coefficient
1.7
Sevoflurane Physical Property: Muscle/Blood coefficient
3.1
Sevoflurane Physical Property: Fat/Blood coefficient
48
Sevoflurane Cardiovascular Effects: myocardial contractility
dose dependent myocardial contractility, CO and SVR
Sevoflurane Cardiovascular Effects: dilation or constriction?
less arterial vasodilation and less decrease in SVR than iso
Sevoflurane Cardiovascular Effects: myocardial contractility
- decrease compared to iso
- decrease MVo2
- decrease coronary vascular resistance
Sevoflurane Cardiovascular Effects: SNS
does not appear to cause an increase in SNS like des does
Sevoflurane Cardiovascular Effects: steal
does not cause coronary artery steal
Sevoflurane Cardiovascular Effects: arrhythmias
does not cause them like halothane does
Sevoflurane Neurological Effects: cerebral vessels
uncouples auto regulatory response by dilating cerebral vessels
Halothane Neurological Effects: MEP
depress MEP monitoring
sevo metabolized per renal
oxidatively metabolized to hexafluoroisopropanol, formaldehyde, inorganic fluoride and CO2
-increase Fl- can cause renal failure but none reported with sevo
sevo and known renal disease
does use probably with known or suspected risk for renal damage
sevo and Fl- ions in the blood
free Fl concentration of 40-50 mcg/L are nephrotoxic
-results in free ions in the blood
Renal tubular function and sevoflurane
directly inhibits tubular function including Cl transport int he ascending limb of the loop of Henle which leads to concentrating defect
obstetrical and N2o
decreases activity of methionine synthetase and thymidylate synthetase which is important in RNA/DNA replication patterns
-increased risk of miscarriage prior to scavenger system
