Volatile anesthetics

Question 1

Halothane

pros and cons

Answer 1

pros- cheap, nonirritating so can be used for inhalation induction
con- long time to onset/offset, significant myocardial depression, sensitizes myocardium to catecholamines, associated with hepatitis

Question 2

Isoflurane

pros and cons

Answer 2

pro- cheap, excellent renal, hepatic, coronary, cerebral blood flow preservation
con- long time to onset/offset, irritating so cannot be used for inhalation induction

Question 3

Sevoflurane

pros and cons

Answer 3

pro- nonirritating, can be used for inhalation induction, extremely rapid onset/offset
con- expensive, due to risk of “compound A” exposure, must be used at flows>2 L/min, theoretical potential for renal toxicity from inorganic fluoride metabolites

Question 4

Desfluorane

pros and cons

Answer 4

pro- extremely rapid onset/offset
con- expensive, stimulates catecholamine release, possibly increases post-op n/v, requires special active- temperature controlled vaporizer due to high vapor pressure, irritating so cannot be used for inhalation induction

Question 5

Nitrous oxide

pros and cons

Answer 5

pro- decreases volatile anesthetic requirement, cheap, less myocardial depression than volatile agents
con- diffuses freely into gas- filled spaces (bowel, ptx, middle ear, gas bubbles used during retinal surgery), decreases FIO2, increases pulmonary resistance, combustible like oxygen