Indications & Uses
Sevoflurane is used to induce and maintain general anesthesia in adults and children undergoing surgery, whether they are staying in hospital or going home the same day. Each ml of the inhalation liquid contains 100% v/v Sevoflurane USP.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Route of administration: Sevoflurane should be given by inhalation, delivered from a vaporizer. The concentration being delivered should be known, which can be achieved using a vaporizer calibrated specifically for Sevoflurane. It should be administered only by persons trained in giving general anesthesia, and facilities for maintaining a patent airway, artificial ventilation, oxygen enrichment and circulatory resuscitation must be immediately available. Since the level of anesthesia can change rapidly, only vaporizers that produce predictable concentrations of Sevoflurane should be used. General anesthesia must always be given according to the individual patient's response. Pre-anesthetic medication: No specific premedication is either indicated or contraindicated with Sevoflurane. Whether to premedicate, and the choice of premedication, is left to the anesthesiologist's discretion. Induction: Sevoflurane has a nonpungent odor and does not cause respiratory irritability, making it suitable for mask induction in both children and adults. Maintenance: Surgical levels of anesthesia can usually be reached with concentrations of 0.5 to 3% Sevoflurane, with or without the concomitant use of nitrous oxide. Sevoflurane can be given with any type of anesthesia circuit. Use in children and adolescents: The safety and efficacy of induction and maintenance of general anesthesia with Sevoflurane have been established in pediatric patients aged 1 to 18 years.
Side Effects
Sevoflurane can cause a number of side effects. The most frequently reported ones include a slowed heart rate, low blood pressure, restlessness, spasm of the airway (laryngospasm), obstruction of the airway, holding of the breath, increased coughing, a fast heart rate, shivering, drowsiness, excess salivation, and nausea with vomiting.
Cautions & Contraindications
Warnings & Precautions
Because clinical experience in administering Sevoflurane to patients with renal insufficiency (creatinine greater than 1.5 mg/dl) is limited, its safety in these patients has not been established. When used for long procedures at low flow rates, Sevoflurane may be associated with glycosuria and proteinuria. It may present an increased risk in patients with known sensitivity to volatile halogenated anesthetic agents, and it may cause respiratory depression, which can be worsened by opioid premedication or other agents that depress respiration. Reports of QT prolongation have been received, and fatal outcomes of malignant hyperthermia have also been reported. Use of inhaled anesthetic agents has been linked to rare increases in serum potassium levels that have resulted in cardiac arrhythmias and death in pediatric patients during the postoperative period. Episodes of severe bradycardia and cardiac arrest, unrelated to underlying congenital heart disease, have been reported during anesthesia induction with Sevoflurane in pediatric patients with Down syndrome. During induction in this group, heart rate should be closely monitored, and incrementally increasing the inspired Sevoflurane concentration should be considered until a suitable level of anesthesia is achieved. It is advisable to have an anticholinergic and epinephrine on hand when administering Sevoflurane for induction in these patients. During maintenance of anesthesia, increasing the concentration of Sevoflurane produces dose dependent decreases in blood pressure. Excessive decreases in blood pressure or respiratory depression may be related to the depth of anesthesia and can be corrected by lowering the inspired concentration of Sevoflurane. Recovery from general anesthesia should be carefully assessed before a patient is discharged from the post-anesthesia care unit.
Contraindications
It is contraindicated in anyone with a known hypersensitivity to sevoflurane, to other halogenated inhalational anesthetics, or to any other ingredient in this product. It should also not be used in patients with a known or suspected genetic susceptibility to malignant hyperthermia.