Selection Of Anaesthetic Drugs: Halothane, Isoflurane Or Sevoflurane
吸入麻醉藥的選擇:氟烷、異氟烷、七氟烷
Speed of Induction and Recovery誘導與蘇醒速度
Sevoflurane is half as soluble in blood as
isoflurane, which is approximately half as soluble in blood as
halothane. The more insoluble an anaesthetic, the faster the anaesthetic
induction, more rapid the changes in depth and faster the recovery.
Clinically the difference between these agents is not huge, but animals
will recover fastest from sevoflurane and to a lesser degree,
isoflurane, and will be more alert - owners notice this difference!
Speed of recovery is an important consideration for neonates
(C-sections), geriatric patients and for long anaesthetics.
All inhalation anaesthetics cause a dose-dependent
reduction in mean arterial pressure which is caused by a dose-dependent
decrease in cardiac output and stroke volume. There is a tendency for
less cardiac depression with isoflurane and sevoflurane, particularly in
cats, and at deeper levels of anaesthesia. The cardiovascular system
seems to be more tolerant of changes in anaesthetic depth with
isoflurane or sevoflurane compared to halothane.
The arrhythmogenic potential for halothane is much
greater than that for isoflurane- or sevoflurane. This is especially
important for any patient with cardiac disease manifested by an
arrhythmia. In such patients (e.g., gastric dilata-tion), halothane may
be contraindicated.
氟烷相對于異氟烷和七氟烷,更容易引起心率失常。這對于已經有心率失常的心臟病的病號特別重要。
Respiratory Function呼吸功能
All inhalation anaesthetics cause a dose-dependent
respiratory depression, as evidenced by a rise in arterial carbon
dioxide tension with increasing anaesthetic dose. In canine patients,
isoflurane tends to produce the most respiratory depression when
compared to the other inhalation agents. However, in cats, isoflurane
has been shown to cause less respiratory depres-sion when compared to
halothane (there is no comparative data for sevoflurane).
Traditionally, it was thought that the inhalation
anaesthetics were entirely taken up and eliminated by the lungs.
However, of that portion of the anaesthetic taken up by the body's
tissue, 25% of halothane is metabolized, compared to 3% of sevoflurane
and virtually O% for isoflurane This becomes particularly important for
neonatal animals and animals with liver or renal impairment.
In addition, metabolism of inhalation anaesthetics is
an important concern from an occupational health aspect. Since
metabolism of isoflurane, and to a lesser extent sevoflurane, is
minimal, it offers distinct advantages from the perspective of
occupational health exposure. In veterinary practices with good waste
anaesthetic gas management, occupational exposure still occurs at the
time of disconnection, during recovery and when servicing equipment!
Pregnant women should minimize their exposure to
waste anaesthetic gases, particularly those that are highly metabolized
such as halothane and nitrous oxide. AAS advises pregnant woman to wear
face masks that scavenge waste anaesthetic gas while working in
anaesthesia.