Sevoflurane: Brands, Price & Uses in Bangladesh

Sevoflurane is a volatile halogenated inhalational anesthetic agent used exclusively in the hospital/operating-room setting under the care of qualified anesthesia personnel.

Established / FDA-approved uses

• Induction of general anesthesia in adult and pediatric patients for inpatient and outpatient surgery, either alone or in combination with other anesthetic agents.
• Maintenance of general anesthesia in adult and pediatric patients for inpatient and outpatient surgery.

Guideline-supported / adjunct uses

• Preferred agent for inhalational (mask) induction in pediatric patients because of its non-pungent odor and low airway irritability.
• Used as part of balanced anesthesia together with nitrous oxide, oxygen, opioids, and neuromuscular blocking agents.

Sevoflurane is not indicated for any use outside the perioperative/procedural anesthesia setting and is never self-administered by patients.

Sevoflurane must be administered only by persons trained in general anesthesia, using a vaporizer specifically calibrated for Sevoflurane, with continuous monitoring of oxygenation, ventilation, circulation, and temperature, and with equipment for airway management, artificial ventilation, oxygen supplementation, and circulatory resuscitation immediately available.

Induction of anesthesia

Maintenance of anesthesia

Surgical levels of anesthesia are generally maintained with 0.5–3% Sevoflurane, with or without concomitant nitrous oxide, individualized to patient age, response, and depth of anesthesia required. See Use in Special Populations for age- and organ-impairment-based adjustments, and Precautions and Warnings for fresh-gas-flow requirements.

Common

• Nausea and vomiting
• Emergence agitation/delirium (particularly in young children)
• Hypotension or, less often, bradycardia/tachycardia
• Cough, breath-holding, or laryngospasm during induction
• Shivering, headache, dizziness on emergence

Serious (less common)

• Malignant hyperthermia — see Contraindications and Precautions and Warnings.
• Dose-dependent respiratory depression and cardiovascular depression (hypotension, arrhythmia).
• Rare hepatic dysfunction, including isolated reports of hepatitis/hepatic failure.
• QT interval prolongation, rarely associated with arrhythmia.