IUPAC_name = 1,1,1,3,3,3-hexafluoro-2-(fluoromethoxy)propane
CAS_number = 28523-86-6
ATC_prefix = N01
ATC_suffix = AB08
PubChem = 5206
DrugBank = APRD00219
C=4 | H=3 | F=7 | O=1
molecular_weight = 200.055 g/mol
legal_UK = POM
legal_US = Rx-only
Sevoflurane (2,2,2-trifluoro-1- [trifluoromethyl] ethyl fluoromethyl ether), also called fluoromethyl hexafluoroisopropyl ether, is a sweet-smelling, non-flammable, highly fluorinated methyl isopropyl ether used for induction and maintenance of
general anesthesia. Together with desflurane, it is replacing isofluraneand halothanein modern anesthesiologyFact|date=April 2008. It is often administered in a mixture of nitrous oxideand oxygen. After desfluraneit is the volatile anestheticwith the fastest onset and offset. Though desflurane has the lowest blood/gas coefficient of the currently used volatile anesthetics, sevoflurane is the preferred agent for mask induction due to its lesser irritation to mucous membranes.
Though it vaporizes readily, it is a liquid at room temperature and is administered via an
anesthetic vaporizerattached to an anesthetic machine.
It was introduced into clinical practice initially in Japan in 1990. The rights for sevoflurane in the US and other countries are held by
Sevoflurane forms at least two degradation products, "Compound A" [fluoromethyl-2,2-difluoro-1-(trifluoromethyl)vinyl ether] and "Compound B" [1,1,1,3,3-pentafluoro-2-(fluoromethoxy)-3-methoxypropane] , on contact with the
soda limein a rebreathing apparatus, which absorbs exhaled carbon dioxide, especially at higher temperatures and when the soda lime is desiccated. Compound A has been shown to cause renal necrosis in rats. In humans, direct histological evidence of renal toxicity has not been demonstrated, although there is dose-related proteinuria, glycosuriaand enzymuria. During low-flow anaesthesia, when the lower fresh gas flow leads to decreased flushing of the circuit and increased temperature of the soda lime, Compound A may build up to clinically significant levels. As a result, sevoflurane is sometimes administered with a minimum fresh gas flow of 2 liters per minute, making it a relatively expensive choice for maintaining general anesthesia.
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