New drugs in anesthesia

Abstract

The lower solubilities of desflurane and sevoflurane provide a clear advantage over older potent agents, permitting more precise control over the delivery of anesthesia and more rapid recovery from anesthesia. Other pharmacological properties of these two agents at concentrations of 1 MAC or less differ little from those of older agents. Sevoflurane differs from desflurane in that it is without pungency and useful for induction of anesthesia by inhalation. It is less prone to increase pulse rate at higher concentrations. Desflurane also can cause transient increases in pulse rate and blood pressures when its concentration is rapidly increased above 6%. Sevoflurane has the disadvantage of vulnerability to degradation in vitro and in vivo, raising a concern regarding a subtle toxicity. Although neither of these new anesthetics can be said to be ideal, each may be a step in that direction.