Desflurane

Desflurane is a prescription medication used for maintenance of general anesthesia. Desflurane may be used alone or with other medications.

• Desflurane is available under the following different brand names: Suprane 

Common side effects of Desflurane include:

• Increased saliva,
• Redness in the eyes or eyelids,
• Anxiety,
• Hyperventilation,
• Irritability,
• Itching skin,
• Restlessness,
• Shaking, and
• Trouble sleeping

Serious side effects of Desflurane include:

• Hives,
• Difficulty breathing,
• Swelling of the face, lips, tongue, or throat,
• Bluish lips or skin,
• Body aches or pain,
• Congestion,
• Cough,
• Sore throat,
• Fever,
• Hoarseness,
• Runny nose,
• Breathing that stops,
• Tender or swollen glands in the neck,
• Tightness in the chest,
• Trouble swallowing,
• Voice changes,
• Blurred vision,
• Chest pain or discomfort,
• Dizziness,
• Fast, pounding, or irregular heartbeat,
• Headache,
• Lightheadedness,
• Fainting,
• Nervousness,
• Pounding in the ears,
• Slow or irregular heartbeat,
• Unusual tiredness,
• Dark urine,
• Difficulty moving,
• Dark urine,
• Feeling flushed or redness of the skin (especially on the face and neck),
• Tiredness,
• Weakness,
• Joint pain,
• Light-colored stools,
• Muscle aches,
• Muscle cramps,
• Nausea,
• Vomiting,
• Noisy breathing,
• Pain or discomfort in the arms, jaw, back, or neck,
• Sweating,
• Swollen joints,
• Upper right abdominal pain,
• Yellowing of the eyes or skin (jaundice),
• Abdominal pain,
• Confusion,
• Convulsions,
• Little or no urine,
• Dry mouth,
• Increased thirst,
• Loss of appetite,
• Weakness,
• Heaviness of the legs,
• Loss of blood pressure or pulse, and
• Cardiac arrest

Rare side effects of Desflurane include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Inhalation solution

• 240 mL (100%)

General Anesthesia

Adult dosage

• Induction: Initial 3% inhaled, increase by 0.5-1% increments every 2-3Breaths
• Maintenance: 2.5-8.5% with or without nitrous oxide

Pediatric dosage

• Maintenance: 5.2-10% with or without nitrous oxide

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Desflurane has severe interactions with the following drugs
  • dronedarone
• Desflurane has serious interactions with at least 166 other drugs.
• Desflurane has moderate interactions with at least 143 other drugs.
• Desflurane has minor interactions with the following drugs:
  • amitriptyline
  • amoxapine
  • benazepril
  • captopril
  • clomipramine
  • desipramine
  • dosulepin
  • doxepin
  • imipramine
  • lofepramine
  • maprotiline
  • nortriptyline
  • protriptyline
  • trazodone
  • trimipramine

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Sensitivity to halogenated agents
• Genetic susceptibility to malignant hyperthermia
• Patients in whom general anesthesia is contraindicated
• Induction of anesthesia in pediatric patients
• History of moderate to severe hepatic dysfunction following anesthesia with desflurane or other halogenated agents

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Desflurane?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Desflurane?”

Cautions

• Volatile liquid; use an appropriate vaporizer for inhalation
• Not approved for maintenance of anesthesia in non-intubated children due to an increased incidence of respiratory adverse reactions, including coughing (26%), laryngospasm (13%), and secretions (12%)
• Decrease in hepatic and renal blood flow reported
• Risk of hyperkalemia increased in pediatric patients with underlying neuromuscular disease (. g, Duchenne muscular dystrophy)
• Increase in intracranial pressure reported with the use
• Emergence from anesthesia in children may evoke a brief state of agitation that may hinder cooperation
• Malignant hyperthermia may occur in susceptible individuals; fatal outcomes reported
• Should not be used as the sole agent of induction in patients with CAD, heart failure, or patients where an increase in heart rate or BP is undesirable
• Children, particularly if 6 years old or younger, under anesthetic maintenance of desflurane delivered via laryngeal mask airway (LMA™ mask) are at increased risk for adverse respiratory reactions, including coughing and laryngospasm, especially with the removal of the laryngeal mask airway under deep anesthesia; closely monitor these patients for signs and symptoms associated with laryngospasm and treat accordingly
• When used for maintenance of anesthesia in children with asthma or a history of recent upper airway infection, there is an increased risk for airway narrowing and increases in airway resistance; closely monitor these patients for signs and symptoms associated with airway narrowing and treat accordingly
• QTc prolongation, associated with torsade de pointes, reported; carefully monitor cardiac rhythm when administering the drug to susceptible patients (. g., patients with congenital Long QT Syndrome or patients taking drugs that can prolong the QT interval)
• General anesthetics and sedation drugs in young children and pregnant women
• Brain development
  • Prolonged or repeated exposure may result in negative effects on fetal or young children’s brain development
  • Caution with use during surgeries or procedures in children younger than 3 years or pregnant women during their third trimester
  • Assess the risk: benefit ratio in these populations, especially for prolonged procedures (. e., above 3 hours) or multiple procedures

Pregnancy and Lactation

• There are no adequate and well-controlled studies in pregnant women; in animal reproduction studies, embryo-fetal toxicity (reduced viable fetuses and/or increased post-implantation loss) was noted in pregnant rats and rabbits administered 1 MAC desflurane for 4 hours a day (4 MAC-hours/day) during organogenesis; there are no data on pregnancy exposures in primates corresponding to periods before the third trimester in humans
• Lactation
  • It is not known whether a drug is excreted in human milk; because many drugs are excreted in human milk, caution should be exercised when administering therapy to a nursing woman