📊 Isoflurane

Structure

FFCFHCClOFCFH

FDA Data Sheet

Basic Information

MAC: 1.21
MAC-BAR: 1.8
MAC-Awake: 0.5 Metabolism %: 0.21
Vapor Pressure: 2381

Blood/Gas: 1.431
Oil/Gas: 911

AgeMACMAC + 70%Nâ‚‚O
26 ± 41.28%0.56%
44 ± 71.15%0.5%
64 ± 51.05%0.37%

How MAC affects HR

AgentMAC value that ↑ HR
Sevoflurane1.5
Isoflurane0.5
Desflurane1.0

Additional Info

  • MH Trigger
  • Pungent
  • Heart rate increases appear to be related to airway irritation and catecholamine release.2 This can be attenuated by the administration of opioids or beta blockade.
  • Sinoatrial node discharge rate is slowed and conduction in the His-Purkinje system is prolonged (prolonged QT interval
  • ↑ RR, bronchodilation
  • ↓ TV, MV
  • Coronary steal is a myth.3
  • Dose dependent depression of the ventilatory response to hypercarbia and hypoxia
  • ↓ ciliary movement and altered mucus characteristics
  • Dose dependent effect on skeletal muscle relaxation
  • Potentiates the action of neuromuscular blockers (greatest with myasthenia gravis)
  • In the presence of a dessicated COâ‚‚ absorber exothermic reaction with volatile anesthetics can lead to fire and/or carbon monoxide formation.
  • Minimal metabolism. Metabolized into flouride ions with can be nephrotoxic although it has not been shown to be clinically significant in patients without kidney disease.1
  • All MAC values can be decreased by co-administered agents (benzodiasepines, opioids, α₂ agonists, etc.)

  1. Isoflurane Data Sheet ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎

  2. Tanaka S, Tsuchida H, Nakabayashi K, Seki S, Namiki A. The effects of sevoflurane, isoflurane, halothane, and enflurane on hemodynamic responses during an inhaled induction of anesthesia via a mask in humans. Anesth Analg. 1996 Apr;82(4):821-6. doi: 10.1097/00000539-199604000-00025. PMID: 8615504. ↩︎

  3. Crystal GJ. Isoflurane and the Coronary Steal Controversy of the 1980s: Origin, Resolution, and Legacy. J Anesth Hist. 2017 Apr;3(2):56-62. doi: 10.1016/j.janh.2017.04.002. Epub 2017 Apr 12. PMID: 28641827. ↩︎