DESFLURANE

Rapid-acting volatile liquid inhalation general anaesthetic

Dosage Forms

Liquid for inhalation

100%

Uses

  • Induction of anaesthesia
  • Maintenance of anaesthesia

Dose and Duration

Individualise dose according to patient’s response. Give by inhalation through a specifically calibrated vaporiser
Induction of anaesthesia
Adult:start with 3% and increase in 0.5–1% increments every 2–3 breaths. 4–11% concentrations usually produce surgical anaesthesia in 2–4 minutes (max up to 15% with oxygen at least 30% and above)
Maintenance of anaesthesia
Adult: 2–6% in nitrous oxide and 2.5–8.5% in oxygen or oxygen enriched air
Child: 5.2–10% with or without concomitant use of nitrous oxide

Contraindications

  • All contraindications to general anaesthesia
  • Known sensitivity to halogenated agents
  • Known genetic susceptibility to malignant hyperthermia
  • Patients at risk of coronary artery disease
  • Induction if increase in heart rate and BP is undesirable

Side Effects

  • Pharyngitis, breath holding
  • Headache
  • Conjunctivitis
  • Nodal arrhythmia, bradycardia, tachycardia, hypertension
  • Apnoea, cough, laryngospasm- only during induction
  • Vomiting, nausea, salivary hypersecretion
  • Increased creatinine phosphokinase
  • Abnormal ECG

Interactions

  • Doxapram, adrenaline, noradrenaline, (increased risk of arrhythmias)
  • Methylphenidate (increased risk of hypertension)

Pregnancy

  • Do not use

Breastfeeding

  • Can be used

Storage

  • Store in an upright position with cap firmly in place

⚠️ Caution

  • May cause depression of neonatal respiration if used during delivery. It is a uterine relaxant and reduces uterine-placental blood flow
  • Resume breast-feeding after sufficient recovery from an aesthesia
  • Use with caution in cases of raised intracranial pressure
  • May cause hepatotoxicity in patients sensitised to halogenated general anaesthetics
  • Monitor blood pressure and heart rate carefully during maintenance