Chemical degradation products can be caused by direct contact inhalation anesthetics in the device with the sorbent . When using the new sorbents sevoflurane is minimal and the risk of decomposition products of degradation are not toxic or not defined. Accelerate the formation of significant amounts of degradation products of sevoflurane occurs during heating of dried sorbent (especially containing sodium hydroxide – Baralyme), increasing the concentration of sevoflurane and reducing the supply of fresh gas in the breathing circuit. Sevoflurane trenbolone acetate is subjected to alkaline degradation in two ways, the first of which is formed on loss of pentaftorizopropenil fluoromethyl ester , known as component A.
In the second case, which is possible only by direct contact with the sevoflurane overdried sorbent dissociates to sevoflurane geksaflyuoroizoprapanola and formaldehyde. Is inactive, it does not have genotoxic and after a quick glucuronidation in the level of toxic action is comparable to sevoflurane. Formaldehyde is present in normal metabolic reactions and in contact with the sorbent overdried in turn decomposes to methanol and formate. Of further formate by heat generated carbon monoxide. The methanol can react with component A, formed by methoxylation further component B. Component B is further elimination with the formation of the components . When still used to a great extent in particular of dried sorbent Baralyme, should expect the formation of formaldehyde, methanol oxide carbon component A and optionally some other products – components B, C and D.
Inhalation use of the drug for the induction of anesthesia causes rapid loss of consciousness, which quickly restored after the termination of anesthesia.
Induction is trenbolone acetate accompanied by minimal signs of excitement and irritation of the upper respiratory tract and causes excess secretion in the tracheobronchial tree and the stimulation of the central nervous system. Like other powerful tools for inhalation anesthesia, sevoflurane causes dose-dependent suppression of the respiratory function and lowering blood pressure. In humans, the threshold level of sevoflurane, cause arrhythmias develop under the influence of adrenaline, was comparable to that of isoflurane and halothane exceed the threshold level.
Has minimal effect on intracranial pressure and does not reduce the response. Sevoflurane has no clinically significant effect on the function of the liver or kidneys and causes no increase renal or hepatic insufficiency. Sevoflurane concentration does not affect the renal function, even after prolonged anesthesia (about 9 hours).
Sevoflurane in oxygen was 2.05% in 40-year-old adult. Trenbolone acetate, as with other halogenated agents, decreases with age and with the addition of nitrous oxide.
Low solubility of sevoflurane in blood provides a rapid increase in alveolar concentration upon administration of general anesthesia and rapid decrease following termination of inhalation. Alveolar concentration ratio and the concentration in the inspired mixture into the phase accumulation after 30 minutes was 0.85 sevoflurane inhalation. The launch phase of the ratio of alveolar concentration after 5 minutes was equal to 0.15.
Distribution and metabolism
Rapid elimination of sevoflurane minimizes lung drug metabolism. In humans, less than 5% of the dose sucked by the action of sevoflurane is metabolised by cytochrome P450 (CYP 2E1) in hexafluoroisopropanol to the release of inorganic fluoride and carbon dioxide (carbon dioxide or one). The resulting hexafluoroisopropanol rapidly conjugated with glucuronic acid and excreted in the urine.Other metabolic routes are not installed sevoflurane. He is the only fluorinated volatile anesthetic agent, is not metabolized to trifluoroacetic acid.
The concentration of fluoride ions is dependent on the duration of general anesthesia, administered sevoflurane concentration and composition of the anesthetic mixture. Barbiturates not cause defluorination of sevoflurane. Approximately 7% of adults who have in clinical studies Abbott inorganic fluorine concentration was measured, they exceed 50 uM; clinically significant changes in renal function in any of these patients did not reveal.
Background and supporting general anesthesia in adults and children during surgery in the hospital and on an outpatient basis.
Hypersensitivity to sevoflurane or other halogenated drugs, confirmed or suspected genetic susceptibility to malignant hyperthermia.
The caution applies Renal impairment sevoflurane safety in this patient group has not been established definitively. Therefore sevoflurane should be used with caution in patients with renal insufficiency.
if the patient has the threat of increased intracranial pressure, the sevoflurane should be used with caution in conjunction with measures aimed at reducing trenbolone acetate the intracranial pressure, such as hyperventilation.
Use during pregnancy and lactation
Pregnancy – Category B
Reproduction studies in animals at doses up to sevoflurane 1 MAC had no effect on reproductive function and damaging effect on the fetus.
Adequate controlled trials have not been conducted in pregnant women, therefore sevoflurane may be used during pregnancy only if clearly needed.
In a clinical study, the safety of sevoflurane was demonstrated for mothers and infants when used for general anesthesia for caesarean section. Sevoflurane Safety during labor and delivery under normal not installed.
Women who breast-feeding
Data on breeding of sevoflurane in breast milk does not. In women, breast-feeding, the drug should be used with caution.
DOSAGE AND ADMINISTRATION
Means for premedication should be selected individually anesthesiologist.
General anesthesia during surgery
during general anesthesia is necessary to know the concentration of sevoflurane, coming from the evaporator. You can use the vaporizer specifically calibrated for sevoflurane.
Introduction of general anesthesia
Dose picked and individually titrated to achieve the desired effect, taking into account the age and condition of the patient. After inhalation of sevoflurane can be administered short-acting barbiturate or other intravenous preparation for the introduction of general anesthesia. For administration of general anesthesia may be used sevoflurane in oxygen or a mixture of oxygen and nitrous oxide. Before surgery sevoflurane inhalation at concentrations up to 8%, usually provides an introduction to general anesthesia in less than 2 minutes in both adults and children alike. cypbol