Eger E I
Department of Anesthesia, University of California, San Francisco.
Anesthesiology. 1994 Apr;80(4):906-22. doi: 10.1097/00000542-199404000-00024.
Desflurane and sevoflurane provide one clear advantage over other currently available potent inhaled anesthetics. Their lower solubilities permit a more precise control over the delivery of anesthesia and a more rapid recovery from anesthesia. Most of their other properties reflect similar properties of their predecessors--with a few exceptions. Indeed, at concentrations of 1 MAC or less, the pharmacologic properties of these two agents differ little if at all. However, in contrast to desflurane, at concentrations exceeding 1 MAC sevoflurane has little or no respiratory irritant properties and may be used to rapidly induce anesthesia. Neither anesthetic seems to materially affect heart rate at concentrations lower than MAC, but at higher concentrations desflurane, but not sevoflurane, may increase heart rate. Desflurane strongly resists biodegradation and degradation by soda lime, whereas sevoflurane is vulnerable to degradation and the degradation by soda lime or Baralyme produces a toxic product. Thus, neither of these new anesthetics can be said to be ideal, but each may be a step in that direction.
地氟烷和七氟烷相对于目前其他可用的强效吸入麻醉剂具有一个明显优势。它们较低的溶解度使得对麻醉给药的控制更为精确，且麻醉恢复更快。它们的大多数其他特性反映了其前身的类似特性——有一些例外。实际上，在1个最低肺泡有效浓度（MAC）或更低的浓度下，这两种药物的药理特性几乎没有差异。然而，与地氟烷不同的是，在超过1个MAC的浓度下，七氟烷几乎没有呼吸刺激性，可用于快速诱导麻醉。在低于MAC的浓度下，这两种麻醉剂似乎都不会对心率产生实质性影响，但在较高浓度下，地氟烷会增加心率，而七氟烷不会。地氟烷强烈抵抗生物降解和碱石灰降解，而七氟烷易被降解，并且碱石灰或钡石灰降解会产生有毒产物。因此，这两种新型麻醉剂都不能说是理想的，但各自都可能朝着理想的方向迈进了一步。
