From the Guidelines
Sevoflurane is a widely used inhalational anesthetic with a Minimum Alveolar Concentration (MAC) of approximately 2% in adults, which is the concentration required to prevent movement in 50% of patients in response to surgical stimulation.
Key Characteristics of Sevoflurane
- It is a clear, colorless liquid at room temperature that vaporizes easily and is administered through a breathing circuit.
- Sevoflurane has a pleasant smell and causes minimal airway irritation, making it a preferred choice for many patients.
- It allows for rapid induction and emergence from anesthesia, which is beneficial for patients undergoing surgery.
- Sevoflurane provides good hemodynamic stability, which is important for maintaining blood pressure and ensuring adequate blood flow to organs during surgery.
Importance of MAC in Anesthesia
- The MAC value is used as a standard measure of potency for inhaled anesthetics and helps guide dosing.
- The MAC value decreases with age and with certain medications like opioids, which means elderly patients and those receiving pain medications typically need less sevoflurane to achieve the same depth of anesthesia 1.
- Close monitoring of age-adjusted minimum alveolar concentration (MAC) is critical to avoid side effects such as hypotension, particularly in patients over 60 years of age 1.
Clinical Considerations
- The choice of anesthetic agent, including sevoflurane, should be based on individual patient factors, such as medical history, current medications, and the type of surgery being performed.
- While sevoflurane has been shown to have potential benefits, such as reducing postoperative nausea and vomiting, the evidence is not conclusive, and more research is needed to fully understand its effects 1.
- As with any anesthetic agent, it is essential to carefully monitor patients receiving sevoflurane and adjust the dose as needed to ensure optimal anesthesia and minimize potential side effects.
From the FDA Drug Label
CLINICAL PHARMACOLOGY Sevoflurane is an inhalational anesthetic agent for use in induction and maintenance of general anesthesia. Minimum alveolar concentration (MAC) of sevoflurane in oxygen for a 40-year-old adult is 2. 1%.
- Sevoflurane is an inhalational anesthetic agent used for induction and maintenance of general anesthesia.
- The Minimum Alveolar Concentration (MAC) of sevoflurane in oxygen for a 40-year-old adult is 2.1% 2.
From the Research
Definition and Properties of Sevoflurane
- Sevoflurane is an ether inhalation general anaesthetic agent with lower solubility in blood than isoflurane or halothane but not desflurane 3.
- It has a non-pungent odor and a low blood: gas partition coefficient, which facilitates rapid mask induction and recovery from anaesthesia 3, 4.
- Sevoflurane produces dose-dependent CNS, cardiovascular, and respiratory depressant effects that generally parallel those of isoflurane 3.
Minimum Alveolar Concentration (MAC) of Sevoflurane
- The minimum alveolar concentration (MAC) of sevoflurane required to prevent movement in response to surgical incision in healthy patients was 1.71 +/- 0.07% (SE) 5.
- The addition of 63.5% end-tidal nitrous oxide allowed a reduction in the alveolar sevoflurane concentration to 0.66 +/- 0.06% (SE), resulting in a 61.4% reduction in sevoflurane MAC 5.
- The MAC of sevoflurane can be influenced by factors such as age, weight, and the presence of other anesthetic agents 5, 6.
Clinical Use and Recovery Characteristics
- Sevoflurane is useful in adults and children for both induction and maintenance of anesthesia in inpatient and outpatient surgery 3, 7, 4.
- It provides a rapid and smooth induction of, and recovery from, anaesthesia, with a low incidence of mild airway complications 3, 4, 6.
- Sevoflurane has a favorable cardiovascular profile and is well-tolerated by adult and pediatric patients during induction of anesthesia 3, 4.