Sevoflurane, sold under the brand name Sevorane, among others, is a sweet-smelling, nonflammable, highly fluorinated methyl isopropyl ether used as an inhalational anaesthetic for induction and maintenance of general anesthesia.
Pregnancy category AU: B2
Routes of administration Inhalation
Drug class Anesthetic
Metabolism Liver by CYP2E1
Metabolites Hexafluoroisopropanol
Elimination half-life 15–23 hours
Excretion Kidney
After desflurane, it is the volatile anesthetic with the fastest onset.
It is one of the most commonly used volatile anesthetic agents, particularly for outpatient anesthesia.
It is used across all ages, but particularly in pediatric anesthesia, as well as in veterinary medicine.
Together with desflurane, sevoflurane is replacing isoflurane and halothane in modern anesthesia practice.
It is often administered in a mixture of nitrous oxide and oxygen.
Sevoflurane is a potent vasodilator.
It induces a dose dependent reduction in blood pressure and cardiac output.
It is a bronchodilator, however.
With pre-existing lung pathology, it may precipitate coughing and laryngospasm.
Sevoflurane reduces the ventilatory response to hypoxia and hypercapnia, and impedes hypoxic pulmonary vasoconstriction.
Its vasodilatory properties can cause it to increase intracranial pressure and cerebral blood flow.
It reduces cerebral metabolic rate.
Adverse effects: Rare reports involving adults with symptoms similar to halothane hepatotoxicity.
There is it a high incidence (>30%) of agitation and delirium in preschool children undergoing minor noninvasive surgery.
Sevoflurane is the preferred agent for mask induction due to its lesser irritation to mucous membranes.
Sevoflurane is an inhaled anesthetic that is often used to induce and maintain anesthesia in children for surgery.
Sevoflurane, may be neurotoxic to the developing brain.
Sevoflurane may accelerate existing Alzheimer’s or existing tau protein to spread.
Sevoflurane and certain other anesthetics may affect cognitive function
Sevoflurane acts as a positive modulator of the GABAA receptor in electrophysiology studies of neurons and recombinant receptors.
It also acts as an NMDA receptor antagonist, potentiates glycine receptor currents, and inhibits nAChR and 5-HT3 receptor currents.
Sevoflurane is a greenhouse gas:The twenty-year global-warming potential, for sevoflurane is 349, however this is significantly lower than isoflurane or desflurane.