Desflurane

Structural formula
General
Non-proprietary name	Desflurane
other names	2- (difluoromethoxy) -1,1,1,2-tetrafluoroethane; ( RS ) -2- (difluoromethoxy) -1,1,1,2-tetrafluoroethane;
Molecular formula	C 3 H 2 F 6 O
External identifiers / databases
EC number	688-023-8
ECHA InfoCard	100.214.382
PubChem	42113
DrugBank	DB01189
Wikidata	Q419383
Drug information
ATC code	N01 AB07
Drug class	Inhalation anesthetic
properties
Molar mass	168.04 g mol −1
density	1.4540 g cm −3 (20 ° C); 1.4768 g cm −3 (15 ° C);
boiling point	22.8 ° C; 23.35 ° C; 23.5 ° C;
Vapor pressure	885 hPa (20 ° C)
solubility	practically insoluble in water
safety instructions
	Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed
GHS hazard labeling ; no classification available
Global warming potential	2540
	As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Desflurane is an inhalation anesthetic from the Flurane group . It has a good hypnotic , but only weak analgesic and muscle-relaxing effect. Desflurane is a standard anesthetic used in anesthesia . It is characterized by rapid flooding and draining and thus good controllability as well as good circulatory stability when used. Desflurane was introduced to the clinic in 1991 in the USA and 1995 in Germany . In Germany, Austria and Switzerland it is sold by Baxter under the trade name Suprane .

chemistry

properties

The density of desflurane as a liquid is 1.48 g / ml. Information on the boiling point varies between 22.8 ° C and 23.5 ° C. The vapor pressure is 885 hPa at 20 ° C. Due to this low boiling point, special evaporator technology is required.

Stereochemistry

Desflurane is a racemate , i.e. a 1: 1 mixture of the following two enantiomers:

Enantiomers of desflurane
( R ) -enantiomer	( S ) -enantiomer

pharmacology

The blood-gas distribution coefficient of desflurane is 0.42, i.e. at a concentration of 1 percent by volume (vol%) in the alveoli , the concentration in the blood is 0.42 vol%. The low solubility causes a quick sleep and wake up phase. The minimum alveolar concentration is 6%, making desflurane less potent than the essentially similar inhalation anesthetics isoflurane or sevoflurane . Since desflurane irritates the mucous membranes , it is not suitable for induction of anesthesia by inhalation. The irritation of the airways can cause bronchospasm or laryngospasm .

The metabolism rate of desflurane is minimal and is below 0.1%, which means that the likelihood of liver damage is very low, so it can also be used in patients with pre-existing liver disease. Like the other inhalation anesthetics, desflurane increases intracranial pressure and can trigger malignant hyperthermia .

By reaction with soda lime may be carbon monoxide (CO) are produced, which in particular in the dried CO ₂ - absorbers is the case and high gas concentrations.

environment

The lifetime in the atmosphere is 14 years, the global warming potential 2540 and the emissions are (estimated) 960 tons per year.

literature

Rui Sun, Mehernoor F. Watcha, Paul F. White, Gary D. Skrivanek, James D. Griffin, Louis Stool, Mark T. Murphy: A cost comparison of methohexital and propofol for ambulatory anesthesia. In: Anesthesia & Analgesia . 89, 2, Aug. 1999, pp. 311-316, PMID 10439739 , online (PDF; 167 kB) .

Individual evidence

↑ ^a ^b David R. Lide (Ed.): CRC Handbook of Chemistry and Physics . 90th edition. (Internet version: 2010), CRC Press / Taylor and Francis, Boca Raton, FL, Physical Constants of Organic Compounds, pp. 3-474.
↑ ^a ^b ^c ^d ^e ^f ^g Entry on desflurane in the GESTIS substance database of the IFA , accessed on December 7, 2019(JavaScript required) .
^ ^A ^b ^c ^d ^e ^f Rolf Rossaint, Christian Werner, Bernhard Zwissler (eds.): Die Anästhesiologie . General and special anesthesiology, pain therapy and intensive care medicine. 2nd Edition. Springer, Heidelberg 2008, ISBN 978-3-540-76301-7 , pp. 297-320 .
↑ This substance has either not yet been classified with regard to its hazardousness or a reliable and citable source has not yet been found.
↑ ^a ^b Martin K. Vollmer, Tae Siek Rhee, Matt Rigby, Doris Hofstetter, Matthias Hill, Fabian Schoenenberger, Stefan Reimann: Modern inhalation anesthetics: Potent greenhouse gases in the global atmosphere . In: Geophysical Research Letters . tape 42 , no. 5 , March 16, 2015, p. 1606–1611 , doi : 10.1002 / 2014GL062785 .
↑ Michael Heck, Michael Fresenius: Repetitorium Anaesthesiologie. Preparation for the anesthesiological specialist examination and the European diploma in anesthesiology. 3rd, completely revised edition. Springer, Berlin / Heidelberg / New York et al. 2001, ISBN 3-540-67331-8 , p. 804.
↑ Red List online, as of September 2009.
↑ AM comp. d. Switzerland, as of September 2009.
↑ AGES-PharmMed. Status: May 2011.
↑ Rote Liste Service GmbH (ed.): Rote Liste 2017 . List of medicinal products for Germany (including EU approvals and certain medical devices). 57th edition. Frankfurt / Main 2017, ISBN 978-3-946057-10-9 , pp. 175 .
↑ Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 11 f.

[CRC-1] David R. Lide (Ed.): CRC Handbook of Chemistry and Physics . 90th edition. (Internet version: 2010), CRC Press / Taylor and Francis, Boca Raton, FL, Physical Constants of Organic Compounds, pp. 3-474.

[GESTIS-2] ↑ ^a ^b ^c ^d ^e ^f ^g Entry on desflurane in the GESTIS substance database of the IFA , accessed on December 7, 2019(JavaScript required) .

[Rossaint-3] A ^b ^c ^d ^e ^f Rolf Rossaint, Christian Werner, Bernhard Zwissler (eds.): Die Anästhesiologie . General and special anesthesiology, pain therapy and intensive care medicine. 2nd Edition. Springer, Heidelberg 2008, ISBN 978-3-540-76301-7 , pp. 297-320 .

[NV-4] This substance has either not yet been classified with regard to its hazardousness or a reliable and citable source has not yet been found.

[vollmer-5] Martin K. Vollmer, Tae Siek Rhee, Matt Rigby, Doris Hofstetter, Matthias Hill, Fabian Schoenenberger, Stefan Reimann: Modern inhalation anesthetics: Potent greenhouse gases in the global atmosphere . In: Geophysical Research Letters . tape 42 , no. 5 , March 16, 2015, p. 1606–1611 , doi : 10.1002 / 2014GL062785 .

[6] Michael Heck, Michael Fresenius: Repetitorium Anaesthesiologie. Preparation for the anesthesiological specialist examination and the European diploma in anesthesiology. 3rd, completely revised edition. Springer, Berlin / Heidelberg / New York et al. 2001, ISBN 3-540-67331-8 , p. 804.

[7] Red List online, as of September 2009.

[8] AM comp. d. Switzerland, as of September 2009.

[9] AGES-PharmMed. Status: May 2011.

[Rote_Liste-10] Rote Liste Service GmbH (ed.): Rote Liste 2017 . List of medicinal products for Germany (including EU approvals and certain medical devices). 57th edition. Frankfurt / Main 2017, ISBN 978-3-946057-10-9 , pp. 175 .

[11] Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 11 f.