Kinetics and potency of desflurance (I-653) in volunteers

Abstract

The inhalation anesthetic, desflurance (I-653), is a methyl ethyl ether halogenated entirely with fluorine and differing from isoflurance only in the substitution of fluorine for chlorine on the alpha-ethyl carbon. Relative to presently used potent inhalation anesthetics, desflurane has low blood/gas (0.42) and oil/gas (18.7) partition coefficients. These indicate that it will undergo rapid washin and washout (and hence rapid induction of and recovery from anesthesia) and have a MAC value of about 5%. In the present study we demonstrate that desflurane possesses these characteristics in healthy young volunteers. After a 10-min exposure to desflurane the ratio of alveolar (FA) (determined by end-tidal sampling) to inspired (FI) concentration (FA/FI) was 0.82. Washout was similarly rapid; 10 min after discontinuing administration of desflurane, the alveolar concentration relative to the last concentration during administration of anesthetic (FAO) was 0.11 (FA/FAO). These values are similar to those for nitrous oxide. Volunteers responded to commands an average of 2.7 min after discontinuing anesthetic administration. The values for MAC-awake and MAC (the latter determined by tetanic stimulation of the ulnar nerve using surface electrodes) were 2.42% and 4.58% and the ratio of the former to the latter was 0.53.