Sevoflurane

Structural formula
General
Non-proprietary name	Sevoflurane
other names	Ultan; 1,1,1,3,3,3-hexafluoro-2- (fluoromethoxy) propane;
Molecular formula	C 4 H 3 F 7 O
External identifiers / databases
EC number	643-089-7
ECHA InfoCard	100.171.146
PubChem	5206
ChemSpider	5017
DrugBank	DB01236
Wikidata	Q419394
Drug information
ATC code	N01 AB08
Drug class	Inhalation anesthetic
properties
Molar mass	200.1 g · mol -1
density	1.52 g cm −3
boiling point	58.5 ° C
Vapor pressure	25.8 k Pa (25 ° C)
solubility	bad in water
safety instructions
	Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed
GHS labeling of hazardous substances	no GHS pictograms
	no GHS pictograms
H and P phrases	H: no H-phrases
	P: no P-phrases
Global warming potential	130
	As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Sevoflurane (trade name Sevorane ) is a volatile anesthetic from the Flurane group, first introduced in 1990 in Japan and in Germany in 1996 . It has a good hypnotic , but only weak analgesic and muscle-relaxing effect. Sevoflurane is widely used for anesthesia , especially in pediatric anesthesia.

pharmacology

The blood-gas distribution coefficient of sevoflurane is approx. 0.65, i.e. at a concentration of 1 percent by volume (% by volume) in the alveoli , the concentration in the blood is 0.65% by volume. The low solubility causes a quick sleep and wake up phase. The minimum alveolar concentration is 2%, making sevoflurane less potent than isoflurane . Since sevoflurane does not irritate the mucous membranes and does not have an unpleasant “ethereal” odor, it is also suitable for induction of anesthesia by inhalation. This explains the frequent use in pediatric anesthesia.

The density of sevoflurane is as a liquid 1.52 g / ml, the boiling point is 58.5 ° C, the vapor pressure at 25 ° C 25.8 k Pa .

The metabolism rate of sevoflurane is between 3 and 5%. In addition to hexafluoroisopropanol, inorganic fluoride is released. Neither in healthy people nor in people with kidney disease could an impairment of kidney function ( nephrotoxicity ) due to these metabolic products be shown. However, it was also recommended not to use sevoflurane in patients with pre-existing kidney damage as a precaution. A special feature of sevoflurane is the reaction with the soda lime of the semi-closed anesthetic systems . Various degradation products ( Compound AE ) are created, with the aid of a low fresh gas flow ( low-flow , minimal-flow anesthesia), dry soda lime containing sodium hydroxide or barium hydroxide as a catalyst, and high gas concentrations. Compound A has a kidney-damaging ( nephrotoxic ) effect in animal experiments in high concentrations , but this does not play a role in clinical use in humans. So far, no harmful effects have been demonstrated for Compound BE. Sevoflurane is approved in Germany for low-flow and minimal-flow anesthesia with no time limit.

Manufacturing

Syntheses for sevoflurane are described in the literature.

environment

The lifetime of sevoflurane in the atmosphere is 1.1 years, the global warming potential 130 and the emissions are (estimated) 1,200 tons per year.

literature

M. Alef, G. Oechtering: Practice of inhalation anesthesia . Enke-Verlag, 2003, ISBN 3-8304-1015-8 .

Individual evidence

↑ ^a ^b ^c ^d ^e ^f Rossaint, Werner, Zwissler (ed.): Die Anästhesiologie. General and special anesthesiology, pain therapy and intensive care medicine. 2nd Edition. Springer, Berlin 2008, ISBN 978-3-540-76301-7 , pp. 297-320.
^ ^A ^b R. Sun, MF Watcha, PF White, GD Skrivanek, JD Griffin, L. Stool, MT Murphy: A cost comparison of methohexital and propofol for ambulatory anesthesia. In: Anesth Analg. 89 (2), Aug 1999, pp. 311-316. PMID 10439739 .
↑ ^a ^b Junji Murata, Shiro Yamashita, Minoru Akiyama, Shinichiro Katayama, Toshihiko Hiaki, Akira Sekiya: Vapor Pressures of Hydrofluoroethers . In: Journal of Chemical & Engineering Data . tape 47 , no. 4 , July 2002, p. 911-915 , doi : 10.1021 / je010322y .
↑ ^a ^b ^c data sheet Fluoromethyl 1,1,1,3,3,3-hexafluoroisopropyl ether, 98 +% from AlfaAesar, accessed on December 7, 2019 ( PDF )(JavaScript required) .
↑ ^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. 2001, p. 804.
^ W. List, PM Osswald, I. Hornke (Ed.): Complications and dangers in anesthesia . 4th edition. Springer, Berlin 2003, ISBN 978-3-642-63054-5 , pp. 148 .
^ H. Förster, UH Warnken, F. Asskali: [Various reactions of sevoflurane with the individual components of soda lime]. In: Anaesthesiologist. 46 (12), Dec 1997, pp. 1071-1075. PMID 9451491 .
^ Axel Kleemann , Jürgen Engel, Bernd Kutscher, Dietmar Reichert: Pharmaceutical Substances. 4th edition. 2 volumes published by Thieme-Verlag, Stuttgart 2000, ISBN 1-58890-031-2 ; online since 2003 with biannual additions and updates.

[Rosaint-1] ↑ ^a ^b ^c ^d ^e ^f Rossaint, Werner, Zwissler (ed.): Die Anästhesiologie. General and special anesthesiology, pain therapy and intensive care medicine. 2nd Edition. Springer, Berlin 2008, ISBN 978-3-540-76301-7 , pp. 297-320.

[sun-2] A ^b R. Sun, MF Watcha, PF White, GD Skrivanek, JD Griffin, L. Stool, MT Murphy: A cost comparison of methohexital and propofol for ambulatory anesthesia. In: Anesth Analg. 89 (2), Aug 1999, pp. 311-316. PMID 10439739 .

[Murata-3] Junji Murata, Shiro Yamashita, Minoru Akiyama, Shinichiro Katayama, Toshihiko Hiaki, Akira Sekiya: Vapor Pressures of Hydrofluoroethers . In: Journal of Chemical & Engineering Data . tape 47 , no. 4 , July 2002, p. 911-915 , doi : 10.1021 / je010322y .

[alfa-4] ta sheet Fluoromethyl 1,1,1,3,3,3-hexafluoroisopropyl ether, 98 +% from AlfaAesar, accessed on December 7, 2019 ( PDF )(JavaScript required) .

[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. 2001, p. 804.

[7] W. List, PM Osswald, I. Hornke (Ed.): Complications and dangers in anesthesia . 4th edition. Springer, Berlin 2003, ISBN 978-3-642-63054-5 , pp. 148 .

[8] H. Förster, UH Warnken, F. Asskali: [Various reactions of sevoflurane with the individual components of soda lime]. In: Anaesthesiologist. 46 (12), Dec 1997, pp. 1071-1075. PMID 9451491 .

[A._Kleemann-9] Axel Kleemann , Jürgen Engel, Bernd Kutscher, Dietmar Reichert: Pharmaceutical Substances. 4th edition. 2 volumes published by Thieme-Verlag, Stuttgart 2000, ISBN 1-58890-031-2 ; online since 2003 with biannual additions and updates.