Sevoflurane (DB01236): A Comprehensive Pharmacological Review

1. Introduction

1.1. Overview of Sevoflurane as an Inhalational Anesthetic Agent

Sevoflurane is a highly fluorinated methyl isopropyl ether, widely utilized as a volatile inhalational anesthetic for the induction and maintenance of general anesthesia across diverse patient populations, including adults and pediatrics, for both inpatient and outpatient surgical interventions.[1] Its clinical utility is largely attributed to a favorable combination of properties: a rapid, smooth onset of action and quick emergence from anesthesia, a non-pungent, pleasant odor which facilitates mask induction (particularly advantageous in pediatric patients), and a general lack of irritation to the respiratory tract.[1] These characteristics, alongside a generally well-tolerated safety profile and predictable pharmacokinetics, have positioned sevoflurane as a cornerstone agent in contemporary anesthetic practice.[1]

The landscape of inhalational anesthesia has seen a progressive shift, with agents like sevoflurane, often alongside desflurane, increasingly supplanting older volatile anesthetics such as isoflurane and halothane in modern clinical settings.[11] Sevoflurane's global adoption since its introduction reflects its perceived advantages in clinical practice.[1] This evolution is driven by a pursuit of anesthetic agents that offer enhanced control, improved patient experience, and more favorable recovery profiles. Older agents, while effective, presented certain limitations; for instance, isoflurane has a slower onset and offset, and halothane carried concerns regarding arrhythmogenicity and hepatotoxicity. Sevoflurane's low blood:gas solubility coefficient is a primary determinant of its rapid induction and emergence characteristics, a significant improvement for both procedural efficiency and patient recovery post-anesthesia.[1] Furthermore, its non-pungent, sweet odor makes it particularly