Inhalational Agents

Inhalational agents currently available are sevoflurane, desflurane, isoflurane, halothane and enflurane.

Sevoflurane is the newest inhalational agent. It has a low solubility and thus has a quick onset and disappearance. It is particularly useful for anesthetic induc tion of children .

Desflurane also has a low solubility, but because it causes irritability of the upper airway it is generally not used for induction. When used at low concentration desflurane has little effect on ventricular function.

Halothane is generally used only for anesthetic induction of pediatric patients. It may cause arrhythmias by sensitization of the conduction pathways of the heart to endogenous or exogenous catecholamines.

Isoflurane may cause significant depression of the right or left ventricular if used at high concentrations for a prolonged period of time. In additional, isoflurane is a vasodilator and may therefore directly reduce systemic vascular resistance. This agent has also been shown to cause coronary steal by diverting blood from ischemic areas of the myocardium toward nonaffected areas, most likely by selective dilatation of the small resistance vessels. When used j udiciously with careful monitoring, however, isoflurane should not adversely affect cardiac function.

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