desfluraani

Desfluraani, commonly known as desflurane, is a volatile inhaled anesthetic in the halogenated ether class used to maintain general anesthesia. It has a chemical formula of C3H2F6O and a molecular weight of about 168 g/mol. It is stored as a liquid at room temperature and delivered as a vapor through a temperature-controlled, heated vaporizer. Desflurane has a high vapor pressure and very low blood-gas solubility, which allows rapid changes in anesthetic depth and an equally rapid recovery after discontinuation.

Administration and clinical use

Desflurane is typically employed for the maintenance phase of anesthesia after induction with another agent. It is not ideal for inhalational induction because of its pungent odor and potential to irritate the airways. It is commonly used in adults and children for longer procedures and is often administered with oxygen or nitrous oxide as part of a standard anesthetic regimen. The need for a specialized vaporizer means its delivery requires a modern anesthesia machine and careful monitoring of ventilation and hemodynamics.

Pharmacokinetics and metabolism

Desflurane is minimally metabolized by the liver, with the majority of the drug being exhaled unchanged. Its rapid onset and offset are largely attributed to its very low blood-gas partition coefficient, which reduces the time required to reach and emerge from anesthetic depth.

Safety and environmental considerations

Possible adverse effects include airway irritation, coughing, laryngospasm, and tachycardia or blood pressure changes, particularly in susceptible individuals. Like other volatile anesthetics, desflurane carries a risk of malignant hyperthermia in susceptible patients. Postoperative nausea and vomiting are possible.

Environmentally, desflurane has a relatively high global warming potential and contributes to greenhouse gas emissions from healthcare. Efforts to minimize fresh gas flow and capture emissions are encouraged where feasible. Brand names include Suprane.