Sevoflurane 327896 204253302 2008-04-08T17:16:45Z Carlo Banez 5493017 {{drugbox | IUPAC_name = 1,1,1,3,3,3-hexafluoro-2-(fluoromethoxy)propane | image = Sevoflurane2.png | image2 = Sevoflurane-3D-balls.png | CAS_number = 28523-86-6 | ATC_prefix = N01 | ATC_suffix = AB08 | ATC_supplemental = | PubChem = 5206 | DrugBank = APRD00219 | C=4 | H=3 | F=7 | O=1 | molecular_weight = 200.055 g/mol | bioavailability = | protein_bound = | metabolism = | elimination_half-life = | pregnancy_category = | legal_UK = POM | legal_US = Rx-only | legal_status = | routes_of_administration = }} '''Sevoflurane''' (2,2,2-trifluoro-1-[trifluoromethyl]ethyl fluoromethyl ether), also called '''fluoromethyl hexafluoroisopropyl ether''', is a sweet-smelling, non-flammable, highly fluorinated methyl isopropyl ether used for induction and maintenance of [[general anesthesia]]. Together with [[desflurane]], it is replacing [[isoflurane]] and [[halothane]] in modern [[anesthesiology]]{{Fact|date=April 2008}}. It is often administered in a mixture of [[nitrous oxide]] and oxygen. After [[desflurane]] it is the [[volatile anesthetic]] with the fastest onset and offset. Though desflurane has the lowest blood/gas coefficient of the currently used volatile anesthetics, sevoflurane is the preferred agent for mask induction due to its lesser irritation to mucous membranes. Though it vaporizes readily, it is a liquid at room temperature and is administered via an [[anesthetic vaporizer]] attached to an [[anesthetic machine]]. It was introduced into clinical practice initially in Japan in 1990. The rights for sevoflurane in the US and other countries are held by [[Abbott Laboratories]]. Sevoflurane forms at least two degradation products, ''Compound A'' [fluoromethyl-2,2-difluoro-1-(trifluoromethyl)vinyl ether] and ''Compound B'' [1,1,1,3,3-pentafluoro-2-(fluoromethoxy)-3-methoxypropane], on contact with the [[soda lime]] in a [[rebreather|rebreathing apparatus]], which absorbs exhaled [[carbon dioxide]], especially at higher temperatures and when the soda lime is desiccated. Compound A has been shown to cause renal necrosis in rats. In humans, direct histological evidence of renal toxicity has not been demonstrated, although there is dose-related [[proteinuria]], [[glycosuria]] and enzymuria. During low-flow anaesthesia, when the lower fresh gas flow leads to decreased flushing of the circuit and increased temperature of the soda lime, Compound A may build up to clinically significant levels. As a result, sevoflurane is sometimes administered with a minimum fresh gas flow of 2 liters per minute, making it a relatively expensive choice for maintaining general anesthesia. ===Physical properties=== {| |[[Boiling point]]: ||align=right| 58.6 °C || (at 101.325 kPa) |- |[[Density]]: ||align=right| 1.517–1.522 g/cm³|| (at 20 °C) |- |[[Minimum alveolar concentration|MAC]] : ||align=right| 2 vol % || |- |[[Molecular Weight]]: ||align=right| 200 [[unified atomic mass unit|u]]|| |- |[[Vapor pressure]]: ||align=right| 157 mmHg (20.9 kPa)|| (at 20 °C) |- | ||align=right|197 mmHg (26.3 kPa) || (at 25 °C) |- | ||align=right|317 mmHg (42.3 kPa) || (at 36 °C) |- |Blood:Gas Partition Coefficient: ||align=right| 0.68|| |- |Oil:Gas Partition Coefficient: ||align=right| 47|| | |} ==External links== * [http://www.priory.com/anaesthesia/propofol_and_sevoflurane.htm] {{General anesthetics}} [[Category:Anesthetics]] [[Category:Ethers]] [[Category:Organofluorides]] [[de:Sevofluran]] [[fr:Sévoflurane]] [[it:Sevoflurano]] [[nl:Sevofluraan]] [[pl:Sewofluran]]