デスフルラン
デスフルランはハロゲン化揮発性吸入麻酔薬であり、イソフルランと非常に似た化学構造を持っています。最大の臨床的利点は、**非常に迅速な麻酔導入と覚醒**です。沸点が室温に近いため、専用の加熱・加圧式気化器が必要です。刺激臭があるため、マスク導入には適していません。
作用機序: While the exact mechanism of inhalant anesthetics remains incompletely understood, desflurane is believed to produce general anesthesia by interacting with the **lipid matrix of neuronal membranes** and modulating multiple ligand-gated ion channels in the central nervous system. **Mechanistic Pathways:** * **GABA_A and Glycine Receptors:** Potentiates inhibitory neurotransmission → CNS depression. * **NMDA Receptors:** Inhibits excitatory glutamatergic transmission. **Minimum Alveolar Concentration (MAC) in Oxygen:** * Dogs: 7% * Cats: 9.8% * Horses: 7.23% * Rabbits: 8.9% * Alpacas/Llamas: 7.8-8.0% *Note: Desflurane causes dose-dependent cardiovascular (hypotension) and respiratory depression, but does not sensitize the myocardium to catecholamine-induced arrhythmias.*
動物種別の用量
- General Anesthesia (Clinically useful concentrations) · Induction = 8-15%; Maintenance = 5-9% · Inhalation · Continuous · As needed
- General Anesthesia (Emergency patients) · 6% · Inhalation · Continuous · As needed · Approximate MAC for emergency patients
- General Anesthesia (Following IV induction) · start with a vaporiser setting of about 8% (around MAC in most animals), increasing the concentration as required. · Inhalation · Continuous · As needed
- General Anesthesia (Clinically useful concentrations) · Induction = 8-15%; Maintenance = 5-9% · Inhalation · Continuous · As needed
- General Anesthesia (Emergency patients) · 6% · Inhalation · Continuous · As needed · Approximate MAC for emergency patients
- General Anesthesia (Following IV induction) · start with a vaporiser setting of about 8% (around MAC in most animals), increasing the concentration as required. · Inhalation · Continuous · As needed
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Hypersensitivity to desflurane or other halogenated anesthetic agents
- History of or predilection towards malignant hyperthermia
有害事象
- Hypotension (dose-dependent)
- Respiratory depression (dose-dependent)
- Respiratory irritation and salivation (especially with mask induction)
- Sympathetic stimulation (tachycardia/hypertension) with rapid increases in concentration
- Malignant hyperthermia (in susceptible individuals, though incidence may be lower than other halogenated agents)
- Transient increases in glucose and white blood cell count
薬物相互作用
- ACE Inhibitors or other hypotensive agents · Concomitant use may increase risks for severe hypotension.
- Non-depolarizing neuromuscular blocking agents · Additive neuromuscular blockade may occur.
- Succinylcholine · May induce increased incidences of cardiac effects (bradycardia, arrhythmias, sinus arrest, apnea) and trigger malignant hyperthermia in susceptible patients.
モニタリング
- Respiratory rate, rhythm, and ventilatory status (capnography)
- Cardiac rate and rhythm (ECG)
- Arterial blood pressure
- Level of anesthetic depth (jaw tone, palpebral reflex)
- Body temperature
- Neuromuscular function
過量投与
In the event of an overdosage, immediately **discontinue desflurane**. Maintain a patent airway and provide positive pressure ventilation with 100% oxygen. Support cardiovascular function with intravenous fluids and sympathomimetics as necessary.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。