Category:

• General anesthetic

Description:

• Halogenated, inhalation anesthetic

Indications:

• General anesthesia

• Obstetric anesthesia

Contraindications:

• Malignant hyperthermia

• Hepatic disease, head trauma, increased intracranial pressure

Precautions:

• Pregnancy category B; may cause stillbirths

• Elderly

• Myasthenia gravis

• Children

Adverse Reactions (Side Effects):

• carboxymethemoglobinemia, delirium

• fetal abortion, fetal stillbirth, neonatal respiratory depression, teratogenesis

• hepatic necrosis, jaundice, tremor, PVC’s

• restlessness, nausea, vomiting

Dosage:

Solely for inhalation administration and should only be given by individuals trained in the administration of general anesthetics.  Inhaled anesthetics must be individualized according to surgical requirements, patient variables (age, physical condition, etc.), and use of adjunctive agents such as nitrous oxide

• General anesthesia induction: 

  • INH: Adult: begin at 0.5% and increase by 0.5% every few breaths

  • Do not exceed 4.5%

  • Maintenance 0.5%-3%

• Child: 

  • dosage must be individually determined

• Supplemental obstetric anesthesia (caesarian section): 

  • Adult: 

    • INH 0.5%-1%

• Supplemental obstetric anesthesia (vaginal delivery):

  • Adult: 

    • INH 0.25%-1%

Drug interactions:

• Beta-blockers

•  Aminoglycosides

•  Antihypertensive agents

•  Cholinesterase inhibitors

•  Neuromuscular blockers

•  Oxytocics

•  Sympathomimetics