Desflurane

Desflurane (Suprane) shares most of the pharmacological properties of isoflurane. Desflurane has low tissue and blood solubility compared with other halogenated hydrocarbons, and its anesthetic partial pressure is thus established more rapidly. Recovery is similarly prompt when the patient is switched to room air or oxygen. Desflurane's popularity for outpatient procedures stems from its rapid onset and prompt elimination from the body by exhalation. A disadvantage is that desflurane irritates the respiratory tract; thus, it is not preferred for induction of anesthesia using an inhalational technique. However, desflurane may be used to maintain anesthesia after induction with an alternative IV or inhalational agent, preserving the advantage of rapid recovery.

Desflurane, like other halogenated hydrocarbon anesthetics, causes a decrease in blood pressure. The reduced pressure occurs primarily as a consequence of decreased vascular resistance, and since cardiac output is well maintained, tissue perfusion is preserved.

Desflurane stimulates the sympathetic nervous system and causes abrupt transient tachycardia during induction or as the concentration of the agent is raised to meet the patient's changing needs.

Desflurane causes an increase in the rate of ventilation, a decrease in tidal volume, and a decrease in minute volume as inspired concentrations only slightly exceed 1 MAC. Thus should anesthesiologists require desflurane to be administered near or above MAC levels, patients are likely to have marked reductions in PCO2.

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