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Volatile liquid anaesthetics are administered using calibrated vaporisers, using air, oxygen, or nitrous oxide–oxygen mixtures as the carrier gas. It should be noted that they can all trigger malignant hyperthermia.

To prevent hypoxia inhalational anaesthetics must be given with concentrations of oxygen greater than in air.

Side effects

Agitation occurs frequently in children

Contraindications

Malignant hyperthermia: is a rare but potentially lethal complication of anaesthesia. It is characterised by a rapid rise in temperature, increased muscle rigidity, tachycardia, and acidosis. The most common triggers of malignant hyperthermia are the volatile anaesthetics. Suxamethonium has also been implicated, but malignant hyperthermia is more likely if it is given following a volatile anaesthetic. Volatile anaesthetics and suxamethonium should be avoided during anaesthesia in patients at high risk of malignant hyperthermia

Cautions

Renal impairment: Sevoflurane should be avoided or used with caution .

Pregnancy:  Third trimester – Depress neonatal respiration.

Drug interactions: (see notes below).

Interactions:

Sevoflurane has no specific interaction information.

Sevofurane belongs to Anaesthetic, General (volatile liquids) and will have the following interactions.

Drug

Effect of interaction

Adrenaline (epinephrine).

Increased risk of arrhythmias when volatile liquid general anaesthetics given with adrenaline (epinephrine)

Levodopa.

Increased risk of arrhythmias when volatile liquid general anaesthetics given with levodopa

Methylphenidate.

Increased risk of hypertension when volatile liquid general anaesthetics given with methylphenidate

Non-depolarising muscle relaxants.

Volatile liquid general anaesthetics enhance effects of non-depolarising muscle relaxants.

Oxytocic.

Oxytocic effect possibly reduced, also enhanced hypotensive effect and risk of arrhythmias when volatile liquid general anaesthetics given with oxytocin.

Suxamethonium.

Volatile liquid general anaesthetics enhance effects of suxamethonium

Sevoflurane belongs to Anaesthetics, General and will have the following interactions:

Drug

Effect of interaction

ACE inhibitors

Enhanced hypotensive effect when general anaesthetics given with ACE inhibitors

Adrenergic neurone blockers

Enhanced hypotensive effect when general anaesthetics given with adrenergic neurone blockers

Alpha-blockers.

Enhanced hypotensive effect when general anaesthetics given with alpha-blockers.

Angiotensin-II receptor antagonists.

Enhanced hypotensive effect when general anaesthetics given with angiotensin-II receptor antagonists.

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