Desflurane (Suprane). Considerations for introducing the new inhalation anesthetic agent into clinical practice.

Ohmeda PPD is counting on desflurane's decreased solubility, which provides improved control of anesthetic level and allows faster recovery, and its reduced toxicity to the liver and kidney to sufficiently differentiate it from its competitor, isoflurane, to make it the inhalation anesthetic of choice in the future. However, even though initial interest has been high, resistance has arisen for several reasons: Desflurane's high MAC requires reduced fresh-gas flows to keep its rate of consumption down. It may not be suitable for certain applications (e.g., for induction of pediatric patients, for use with patients with tachycardia or hypertension). It is usually necessary to supplement it with an injectable agent for induction. Even though it is superior to other agents with respect to speed of initial recovery, no striking advantage relative to time of discharge from the hospital has been demonstrated. Agent monitors will need to be upgraded or new monitors will need to be purchased if the drug is to be measured. The future prices of the drug and its vaporizer are not certain. All of these factors must be considered before committing to this new technology.