Indications for: SUPRANE
Induction and maintenance of general anesthesia in adults. Maintenance of anesthesia in pediatric patients following induction with agents other than desflurane, and tracheal intubation.
Use desflurane calibrated vaporizer. Individualize. May be premedicated with an opioid and/or benzodiazepine. Induction: usual initial dose at 3% desflurane, may increase in 0.5–1.0% increments every 2–3 breaths. End-tidal concentrations of 4–11% desflurane with and without N2O produced anesthesia within 2–4 mins. After induction with thiopental or propofol: start desflurane at approx. 0.5–1 MAC, whether the carrier gas is O2 or N2O/O2. Surgical maintenance: 2.5–8.5% desflurane with or without N2O. See full labeling for minimum alveolar concentration (MAC) values based on age and nitrous oxide.
Use desflurane calibrated vaporizer. Individualize. Surgical maintenance: usually 5.2–10% desflurane with or without N2O. Intubated maintenance: see full labeling.
Susceptibility to malignant hyperthermia. Patients in whom general anesthesia is contraindicated. Induction of anesthesia in pediatric patients. History of moderate-to-severe hepatic dysfunction with desflurane or other halogenated agents. Sensitivity to halogenated agents.
To be administered only by those experienced in general anesthesia. Have intubation, artificial ventilation, oxygen and circulatory resuscitation available. Not appproved for maintenance of anesthesia in non-intubated children (due to increased incidence of respiratory adverse reactions). Children (esp. ≤6yrs) under maintenance anesthesia via laryngeal mask airway (LMA) are at increased risk of respiratory events (esp. with removal of LMA under deep anesthesia); monitor closely. Increased risk of airway narrowing and resistance in children with asthma or history of recent upper airway infection; monitor closely. Risk of sensitivity hepatitis with previous sensitization to halogenated anesthetics. Hepatic disease; consider alternatives to halogenated anesthetics. Do not use as sole agent for induction in coronary artery disease or where increases in HR or BP are undesirable. Intracranial space occupying lesions; increased cerebrospinal fluid pressure (see full labeling). Latent or overt neuromuscular disease (eg, Duchenne muscular dystrophy). Pediatric neurotoxicity risk with repeated or prolonged use. Susceptibility to QT prolongation (eg, congenital long QT syndrome, concomitant QT-prolonging drugs); monitor cardiac rhythm. Elderly (adjust dose). Labor & delivery. Pregnancy. Nursing mothers.
Caution with desiccated CO2 absorbents; replace before administration. Hyperkalemia with succinylcholine. Antagonized by nitrous oxide. Potentiated by benzodiazepines and opioids. Potentiates neuromuscular blockers (eg, succinylcholine, pancuronium, vecuronium, atracurium); see full labeling.
Coughing, breath holding, apnea, nausea, vomiting, laryngospasm, pharyngitis, oxyhemoglobin desaturation, headache, increased secretions/salivation, conjunctivitis, arrhythmias, hypotension; malignant hyperthermia, perioperative hyperkalemia, QT prolongation, torsade de pointes, transient elevated glucose or WBC counts, post-op agitation in children.
Bottle (240mL)—1, 6