Desflurane

Desflurane
Clinical data
Pronunciation	des-FLOO-rane
Trade names	Suprane
AHFS/Drugs.com	Micromedex Detailed Consumer Information
License data	US DailyMed: Desflurane;
Pregnancy; category	AU: B3; ;
Routes of; administration	Inhalation
ATC code	N01AB07 (WHO) ;
Legal status
Legal status	AU: S4 (Prescription only); BR: Class C1 (Other controlled substances); US: ℞-only;
Pharmacokinetic data
Metabolism	Minimally metabolized
Elimination half-life	Elimination dependent on minute ventilation
Identifiers
	IUPAC name 2-(difluoromethoxy)-1,1,1,2-tetrafluoroethane;
CAS Number	57041-67-5 ;
PubChem CID	42113;
IUPHAR/BPS	7156;
DrugBank	DB01189 ;
ChemSpider	38403 ;
UNII	CRS35BZ94Q;
KEGG	D00546 ;
ChEBI	CHEBI:4445 ;
ChEMBL	ChEMBL1200733 ;
CompTox Dashboard (EPA)	DTXSID80866606 ;
ECHA InfoCard	100.214.382
Chemical and physical data
Formula	C3H2F6O
Molar mass	168.038 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES FC(F)(F)C(F)OC(F)F;
	InChI InChI=1S/C3H2F6O/c4-1(3(7,8)9)10-2(5)6/h1-2H ; Key:DPYMFVXJLLWWEU-UHFFFAOYSA-N ;
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Desflurane (1,2,2,2-tetrafluoroethyl difluoromethyl ether), under the brand name Suprane, is a highly fluorinated methyl ethyl ether used for induction and maintenance of general anesthesia. Desflurane was developed in the 1980s and approved by the FDA in 1992 as a faster acting and clearing inhalant anesthetic compared to previously used inhalant anesthetics. Like halothane, enflurane, and isoflurane, it is a racemic mixture of (R) and (S) optical isomers (enantiomers). It has the most rapid onset and offset of the volatile anesthetic drugs used for general anesthesia due to its low solubility in blood. It is lipophobic and hydrophobic, and therefore does not easily dissolve in blood.

Some drawbacks of desflurane are its low potency, its pungency, and its high cost (though at low flow fresh gas rates, the cost difference between desflurane and isoflurane appears to be insignificant). It may cause tachycardia and airway irritability when administered at concentrations greater than 10% by volume. Due to this airway irritability, desflurane is infrequently used to induce anesthesia via inhalation techniques.

Though it vaporizes very readily, it is a liquid at room temperature. Desflurane has a high vapor pressure and a low boiling point, requiring a specific anesthetic vaporizer. Anaesthetic machines are fitted with a specialized anaesthetic vaporizer unit that heats liquid desflurane at a constant temperature and pressure. This enables the agent to be available at a constant vapor pressure and negating the effects of fluctuating ambient temperatures.

Desflurane, along with enflurane and to a lesser extent isoflurane, has been shown to react with the carbon dioxide absorbent in anesthesia circuits to produce detectable levels of carbon monoxide through degradation of the anesthetic agent. The CO₂ absorbent Baralyme, when dried, is most culpable for the production of carbon monoxide from Desflurane degradation, although it is also seen with soda lime absorbent as well. Dry conditions in the carbon dioxide absorbent are conducive to this phenomenon, such as those resulting from high fresh gas flows.