ISOFLURANE

Volatile liquid halogenated general anaesthetic

Dosage Forms

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Liquid for inhalation

≥99.9%

Uses

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  • General anaesthesia

Dose and Duration

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Induction of anaesthesia
  • Adult and child: starting concentration of 0.5%. Usual dose range of 1.3–3.0% induces surgical anaesthesia in about 7–10 minutes
Maintenance of anaesthesia
  • Adult and child: 1.0–2.5% with oxygen and nitrous oxide or 1.5–3.5% with pure oxygen. Reduce to 0.5% at the end of the operation or to 0% during wound closure. Use 0.5–0.75% in nitrous oxide and oxygen for caesarean section. Ventilate air passages (when administration of anaesthetic agents has stopped) several times with 100% oxygen until complete awakening

Contraindications

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  • Hypersensitivity to isoflurane or other halogenated anaesthetics
  • Known or suspected susceptibility to malignant hyperthermia

Side Effects

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  • Respiratory depression
  • Hypotension
  • Arrhythmias
  • Malignant hyperthermia
  • Anaphylactic reactions
  • Hepatic impairment

Interactions

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

Pregnancy

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  • Do not use

Breast-feeding

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  • Can be used

⚠️ Caution

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  • Isoflurane should be administered by a person well equipped in its use using a specially calibrated vaporizer
  • Isoflurane is a uterine relaxant, reduces uterine-placental blood flow and may cause reproductive toxicity. Only use if benefit outweighs risk at the lowest possible doses
  • Use with caution in patients with raised intracranial pressure and mitochondrial disorders
  • Since isoflurane irritates mucous membranes, it is difficult to use if inhalation anaesthesia is applied via a mask and it may lead to laryngospasms in children