Sevoflow

Sevoflurane is indicated for induction and maintenance of general anesthesia in adult and pediatric patients for inpatient and outpatient surgery. Each ml inhalation liquid contains Sevoflurane USP 100% V/V.

Dosage & Administration

Route of administration
: It should be administered by inhalation delivered from a vaporizer. The concentration of Sevoflurane being delivered from a vaporizer should be known. This may be accomplished by using a vaporizer calibrated specifically for Sevoflurane. Sevoflurane should be administered only by persons trained in the administration of general anesthesia. Facilities for maintenance of a patent airway, artificial ventilation, oxygen enrichment and circulatory resuscitation must be immediately available. Since level of anesthesia may be altered rapidly, only vaporizers producing predictable concentrations of Sevoflurane should be used. The administration of general anesthesia must be individualized based on the patient's response.
Pre-anesthetic medication
: No specific premedication is either indicated or contraindicated with Sevoflurane. The decision as to whether or not to premedicate and the choice of premedication is left to the discretion of the anesthesiologist.
Induction
: Sevoflurane has a nonpungent odor and does not cause respiratory irritability; it is suitable for mask induction in pediatrics and adults.
Maintenance
: Surgical levels of anesthesia can usually be achieved with concentrations of 0.5-3% Sevoflurane with or without the concomitant use of nitrous oxide. Sevoflurane can be administered with any type of anesthesia circuit.
Use in children and adolescents
: The safety and efficacy of induction and maintenance of general anesthesia with sevoflurane have been established in pediatric patients aged 1 to 18 years

The most common side effects are bradycardia, hypotension, agitation, laryngospasm, airway obstruction, breathholding, cough increased, tachycardia, shivering, somnolence, increased salivation, nausea and vomiting.

Because clinical experience in administering Sevoflurane to patients with renal insufficiency (creatinine >1.5 mg/dl) is limited, its safety in these patients has not been established. Sevoflurane may be associated with glycosuria and proteinuria when used for long procedures at low flow rates. Sevoflurane may present an increased risk in patients with known sensitivity to volatile halogenated anesthetic agents. Sevoflurane may cause respiratory depression, which may be augmented by opioid premedication or other agents causing respiratory depression. Reports of QT prolongation have been received. Fatal outcomes of malignant hyperthermia have been reported. Use of inhaled anesthetic agents has been associated with rare increases in serum potassium levels that have resulted in cardiac arrhythmias and death in pediatric patients during the postoperative period. Episodes of severe bradycardia and cardiac arrest, not related to underlying congenital heart disease, have been reported during anesthesia induction with Sevoflurane in pediatric patients with Down syndrome. During induction, closely monitor heart rate and consider incrementally increasing the inspired Sevoflurane concentration until a suitable level of anesthesia is achieved. Consider having an anticholinergic and epinephrine available when administering Sevoflurane for induction in this patient population. During the maintenance of anesthesia, increasing the concentration of Sevoflurane produces dose dependent decreases in blood pressure. Excessive decreases in blood pressure or respiratory depression may be related to depth of anesthesia and may be corrected by decreasing the inspired concentration of Sevoflurane. The recovery from general anesthesia should be assessed carefully before a patient is discharged from the post-anesthesia care unit.

Sevoflurane is a preparation of Sevoflurane, a volatile liquid for inhalation. Sevoflurane is an inhalational anesthetic agent for use in induction and maintenance of general anesthesia. The minimum alveolar concentration (MAC) of Sevoflurane decreases with age. Sevoflurane is weakly soluble in blood and tissue, resulting in the rapid achievement of a sufficient alveolar concentration to produce anesthesia and a subsequent rapid elimination until cessation of anesthesia. Sevoflurane produces loss of consciousness, reversible abolition of pain and motor activity, diminution of autonomic reflexes, respiratory and cardiovascular depression. These effects are dose-dependent. Sevoflurane has a low blood/gas partition coefficient (0.65) leading to a rapid recovery from anesthesia.