Generic drug of the therapeutic class: Anesthesia, resuscitation, analgesics
active ingredients: Isoflurane
Liquid for inhalation by steam
Box of 6 bottles of 250 ml
General anesthesia by inhalation, usable in induction and maintenance.
Dosage AERRANE Liquid for inhalation by vapor Box of 6 bottles of 250 ml
Specially calibrated evaporators for isoflurane should be used to accurately control the concentration of the delivered anesthetic.
The minimum alveolar concentration in middle-aged adults averages 1.15 percent pure oxygen. It is lower in the elderly.
When the carrier gas is a 50 percent oxygen-nitrous oxide mixture, the minimum alveolar concentration of isoflurane is around 0.65 percent.
- Induction of anesthesia:
When isoflurane is used as the only anesthetic induction agent, it is recommended to start the induction with a concentration of 0.5%. Concentrations of 1.3-3.0% usually produce surgical anesthesia in 7-10 minutes.
Because isoflurane has a slightly pungent odor, to prevent coughing, it is best to precede its use by injecting an intravenous anesthetic agent: a fast-acting barbiturate or other product such as propofol, etomidate or midazolam. On the other hand, isoflurane can be used with oxygen or with an oxygen / nitrous oxide mixture.
- Maintenance of anesthesia:
Anesthesia adequate for surgery can be maintained with an isoflurane concentration of 0.5 to 1.5% in a mixture of oxygen / nitrous oxide. A higher isoflurane concentration (0.75 to 2.0%) will be required if isoflurane is given with oxygen alone.
The concentration displayed on the evaporator must be increased when using a circuit with re-inhalation of expired gases with low fresh gas flow.
- Minimum alveolar concentrations of isoflurane in humans (MAC):
. Age 26 + - 4 : O2 = 100%: 1.28%; O2 + N2O (70%): 0.56%.
. Age 44 + - 7 : O2 = 100%: 1.15%; O2 + N2O (70%): 0.50%.
. Age 64 + - 5 : O2 = 100%: 1.05%; O2 + N2O (70%): 0.37%.
This medicine is CONTRAINDICATED in the following cases:
- Hypersensitivity to halogenated anesthetic agents.
- Subjects with personal or family history of malignant hyperthermia.
- Patients with liver disease, jaundice, unexplained fever, or eosinophilia after administration of a halogenated anesthetic.
- Association with non-selective MAOIs.
NOT RECOMMENDED :
This medicine is NOT RECOMMENDED in the following cases:
- In children under 2 years old.
- During pregnancy: Studies in animals have shown a teratogenic effect. In clinical practice, there are currently no data of sufficient relevance to evaluate the possible malformative effect of isoflurane when administered during the first trimester of pregnancy. Although no particular fetotoxic effect has emerged to date, the monitoring of pregnancies exposed to isoflurane is insufficient to exclude any risk. As a result, the use of isoflurane is not recommended during the first trimester of pregnancy, and should be considered at the end of pregnancy and during delivery only if necessary.
- In combination with alpha and beta sympathomimetics (epinephrine or adrenaline, norepinephrine or norepinephrine) and beta sympathomimetics (isoprenaline).
- It is not recommended to use isoflurane in subjects likely to have a malignant hyperthermia (history of stress hyperthermia, myopathies such as muscular dystrophies, King's syndrome, myotonia, central myopathy).
Adverse effects Aerrane
- Hypotension (which tends to become normal with the surgical stimulus).
This drop in blood pressure is related to peripheral vasodilatation directly related to the depth of anesthesia.
- Increased heart rate: under assisted ventilation, in normocapnia, cardiac output tends to be maintained despite the deepening of anesthesia, thanks mainly to an increase in heart rate.
Hypercapnia, which can be observed with spontaneous ventilation, may increase the frequency and cardiac output above their value in the awake person.
- Respiratory depression, very rare observations of bronchospasm.
Very rare reports of cytolytic hepatitis have been reported after anesthesia with isoflurane (see contraindications and warnings).
- Occurred upon awakening of chills, nausea, vomiting.
- As with other anesthetic agents of this type, isoflurane can trigger a state of hypermetabolism of skeletal muscle leading to a high oxygen demand and inducing a clinical syndrome known as malignant hyperthermia (MH). . This syndrome includes nonspecific symptoms such as muscle stiffness, tachycardia, tachypnea, cyanosis, arrhythmia, and unstable blood pressure, as well as elevation of the overall metabolism resulting in elevated body temperature and increased body temperature. CO2 at the end of expiration (PetCO2). Such effects have been observed, in rare cases, in humans after anesthesia with isoflurane (see warnings and precautions for use).
- The pungency of this product and irritation of the respiratory tract causes an induction of anesthesia a little agitated with coughing, blocking the respiration and a slight tendency to laryngeal spasm.