Isoflurane significantly increases cerebral blood flow especially during deep anesthesia. There may be a transient increase in cerebrospinal fluid pressure, which is returned to the source during hyperventilation. When using isoflurane postoperative cerebral complications are relatively rare.
The level of general anesthesia can be quickly and easily changed, so only specially calibrated vaporizers should be used to deliver isoflurane.
With the deepening of general anesthesia mark buildup of arterial hypotension and suppression of respiratory function.
There have been reports of individual cases, increasing the level of carboxyhemoglobin using halogenated anesthetic agents for containing a tren ace, such as dezofluran, enflurane and isoflurane. In the presence of normal wetted increase the concentration of carbon monoxide was observed. When using isoflurane with over dried (in particular containing potassium hydroxide – Baralyme) described rare cases of excessive heating and / or spontaneous ignition in devices for anesthesia . If the anesthesiologist suspects that the tren ace is too dry, then it should be replaced before using isoflurane. When drying of the indicator color changes are not always. Consequently, the lack of color change of the indicator can not be considered evidence of adequate changed regularly, regardless of the color of the indicator. Pregnancy Safety has not been established for pregnant women. Blood loss during abortion using isoflurane comparable to blood loss when using other inhaled anesthetics. There are no adequate data to determine the location of isoflurane anesthesia in obstetrics, except for cesarean section. Women who are breastfeeding Data on excretion in breast milk isoflurane not. In women, breast-feeding, the drug should be used with caution.
DOSAGE AND ADMINISTRATION
For precise control of the feed concentration of isoflurane should be used specifically calibrated vaporizers. General anesthesia of isoflurane in oxygen levels depend on age, decreasing from an average of 1.28% in their twenties to 1.15% for thirty years, and up to 1 , 05% of patients at the sixties. In neonates the of isoflurane in oxygen is 1.6%, in children from 1 to 6 months – 1.87%, and from 6 to 12 months -. 1.80%
Premedication Drugs used for premedication should be selected individually, remembering that isoflurane may induce depression of the respiratory center. Optionally, you can use anticholinergic drugs. Induction of a short-acting barbiturate or other intravenous drugs used for induction of anesthesia, commonly used, followed by inhalation of isoflurane. As an alternative, they may be used with isoflurane with oxygen or nitrous oxide-oxygen mixture. When induction with isoflurane inhalation in early recommended use concentration of 0.5%. Concentrations of 1.5% to 3.0% usually produce surgical level of anesthesia in 7-10 minutes. Maintenance of anesthesia tren ace levels of anesthesia may be maintained 1.0% -2.5% isoflurane in oxygen-nitrous oxide mixtures. When using isoflurane in pure oxygen, the concentration should be increased to 0.5% -1.0%. If required, further use of muscle relaxants. To provide anesthesia for cesarean section use 0.5-0.75% isoflurane in enough oxygen-nitrous oxide mixtures. During maintenance of anesthesia, in the absence of other relevant factors, blood pressure is inversely proportional to alveolar concentration izofluana. With the deepening of anesthesia should reduce the concentration of isoflurane in the inspired mixture, in order to prevent an excessive fall in blood pressure. Elderly: as with other drugs, lower concentrations are required to maintain the level of surgical anesthesia in the elderly. Sedation: can be maintained 0.1-1.0% isoflurane in nitrous oxide-oxygen mixture, the tren ace appropriate dosage is adjusted individually.