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세보플루란

Sevoflurane

Fluoromethyl 2,2,2-trifluoro-1-(trifluoromethyl)ethyl ether (Isopropyl ether derivative)

흡입 마취제InhalationInhalational개고양이소형 포유류페렛말돼지양

다른 이름: SevoFlo · Ultane · Petrem · Sojourn · Sevocris · Sevorane · Sevotek · BAX-3084 · MR-654 · Sevofluranum · Fluoromethyl 2,2,2-trifluoro-1-(trifluoromethyl)ethyl ether

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

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Most species/anesthesia; rapid induction and recovery when intubated

TABLE 127.5. Agent: Sevoflurane. Dosage: To effect15,279. Species/Comments: Most species/anesthesia; rapid induction and recovery when intubated.

고위험인증된 수의사 확인 필요drug_regimen프로토콜 2019감사 dose-audit-mader-reviewed-v1

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

​세보플루란(Sevoflurane)​은 수의학에서 전신 마취의 유도 및 유지에 널리 사용되는 휘발성이 높은 할로겐화 흡입 마취제입니다.

주요 약리학적 특징은 다음과 같습니다:

  • ​낮은 혈액/가스 분배 계수 (0.6)​: 이로 인해 폐포와 동맥 간의 평형이 매우 빠르게 이루어지며, 이소플루란이나 할로탄에 비해 마취 유도 및 회복 시간이 훨씬 짧습니다.
  • ​자극적인 냄새 없음​: 이소플루란과 달리 기도에 자극을 주지 않아 특수 동물, 예민한 고양이, 어린 환축의 ​마스크 또는 챔버 유도​에 선호되는 약물입니다.
  • ​혈역학적 안정성​: 이소플루란보다 심각한 저혈압을 덜 유발하는 경향이 있어 쇠약하거나 노령인 환축에게 특히 유용합니다.

​임상 팁​: 세보플루란은 마취 심도가 매우 빠르게 변할 수 있으므로, 마취 유지 중 우발적인 마취 과다를 방지하기 위해 철저한 모니터링이 필요합니다.

작용 기전

The precise mechanism of inhalant anesthetics remains incompletely elucidated, but they primarily act by disrupting synaptic transmission within the central nervous system.

  • Lipid Matrix Interaction → Alters the function of neuronal membrane proteins.
  • GABA_A Receptors → Potentiates inhibitory neurotransmission, leading to profound CNS depression.
  • NMDA Receptors → Antagonizes excitatory glutamatergic signaling.
  • Glycine Receptors → Enhances inhibitory signaling in the spinal cord, contributing to skeletal muscle relaxation.

Due to its low solubility in blood, minimal amounts of sevoflurane need to dissolve before alveolar partial pressures equilibrate with arterial partial pressures, driving its rapid onset and offset of action.

안전성·주의사항

금기사항

  • Patients with a history or predilection towards malignant hyperthermia
  • Known hypersensitivity to sevoflurane or other halogenated anaesthetics
  • Known or suspected susceptibility to malignant hyperthermia

부작용

  • Dose-dependent hypotension
  • Dose-dependent respiratory depression
  • Gastrointestinal effects (nausea, vomiting, ileus)
  • Myocardial depression and bradycardia (less than halothane)
  • Malignant hyperthermia (rare but life-threatening)
  • Temporary decreases in erythrocyte, white cell counts, and total protein in ferrets
  • Agitation or excitement during rapid recovery
  • Neonatal depression (crosses the placental barrier)

주의

WARNING: Compound A Formation Sevoflurane can react with desiccated (dried out) carbon dioxide absorbents to produce 'Compound A', a known nephrotoxin. Always ensure CO2 absorbents are fresh and avoid using extremely low oxygen flow rates (< 500 mL/min).

  • Rapid Action: Because of its rapid onset, use extreme caution not to overdose during the induction phase.
  • Rapid Recovery: Animals (especially large animals like horses) may wake up abruptly. Appropriate sedation during the recovery phase is critical to prevent injury.
  • Neurologic/Renal Disease: Use with caution in patients with increased CSF pressure, head injury, or renal insufficiency.
  • Species Specifics:
    • Rabbits: Can cause breath holding and struggling; premedication and close observation are required.
    • Guinea Pigs: May have a low margin of safety.
  • Geriatric Patients: May require lower concentrations of inhalation anesthetic.

약물 상호작용

Aminoglycosides, Lincosamides

May enhance neuromuscular blockade

Barbiturates (phenobarbital, pentobarbital)

May increase concentrations of inorganic fluoride

Non-depolarizing neuromuscular blocking agents (atracurium, pancuronium, vecuronium)

Additive neuromuscular blockade may occur

Isoniazid

May increase concentrations of inorganic fluoride

Midazolam

May potentiate sevoflurane effects; decrease MAC

Opiates

May potentiate sevoflurane effects; decrease MAC

St. John's Wort

Increased risk for anesthetic complications; recommend discontinuing 5 days in advance of surgery

Succinylcholine

Sevoflurane may enhance effects

Sympathomimetics (dopamine, epinephrine, norepinephrine, ephedrine)

Sensitizes the myocardium to sympathomimetics (less than halothane); arrhythmias may still result

Tramadol

May decrease MAC requirements

Verapamil

May cause cardiodepression

Sedatives (e.g., alpha-2 agonists, phenothiazines)Major

Reduces the concentration of sevoflurane required to achieve surgical anaesthesia (MAC reduction).

Opioid agonistsMajor

Reduces the dose requirement of sevoflurane.

Nitrous oxideModerate

Reduces the concentration of sevoflurane required to achieve surgical anaesthesia.

Non-depolarizing neuromuscular blocking agentsModerate

Sevoflurane potentiates the duration of action of these agents (greater potentiation compared with halothane).

모니터링

  • Respiratory rate, rhythm, and ventilatory status (capnography recommended)
  • Cardiac rate and rhythm (ECG)
  • Blood pressure (especially in 'at risk' or geriatric patients)
  • Level of anesthetic depth (jaw tone, palpebral reflex, eye position)
  • Body temperature (monitor for hypothermia or sudden spikes indicating malignant hyperthermia)
  • Respiratory rate, rhythm, and depth (Capnography/ETCO2 highly recommended)
  • Arterial blood pressure (hypotension is dose-dependent)
  • Heart rate and rhythm (ECG)
  • Anaesthetic depth (jaw tone, palpebral reflex, eye position)
  • Pulse oximetry (SpO2)

약동학

반감기

고양이Rapid clearance (minutes)말Rapid clearance (minutes)개Rapid clearance (minutes)

흡수

Rapidly absorbed across the alveolar membrane due to a very low blood:gas partition coefficient (0.6).

분포

Rapidly distributes to the CNS and other highly perfused tissues. Plasma protein binding percentage is unknown.

대사

Approximately 3% is metabolized in the liver via the cytochrome P450 2E1 isoenzyme system, producing inorganic fluoride.

배설

The vast majority is excreted rapidly and unchanged via the lungs.

과다투여

In the event of an overdosage, immediately discontinue sevoflurane administration.

  • Maintain a patent airway.
  • Flush the breathing circuit with 100% oxygen.
  • Support respiratory function with positive pressure ventilation if necessary.
  • Support cardiac function and treat severe hypotension with IV fluids and sympathomimetics as clinically indicated.

제품

제형

  • Inhalant liquid for vaporization (250 mL bottles)
  • Inhalational liquid (250 ml bottle)

동물용의약품

  • Sevoflurane in 250 mL bottles: SevoFlo (Halocarbon Prod.)
  • Petrem (Minrad)
  • SevoFlo 250 ml liquid for inhalation
  • Sevotek 250 ml liquid for inhalation

인용의약품

  • Sevoflurane in 250 mL bottles: Ultane (Abbott)
  • Sojourn (Minrad)
  • Sevoflurane 100% liquid for inhalation

규제 현황

European Union✓ 승인됨처방전의약품EMA
🐕 Dogs🐈 Cats

POM-V classification.

United Kingdom✓ 승인됨처방전의약품VMD
🐕 Dogs🐈 Cats

POM-V classification.

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Store at room temperature. Sevoflurane does not react with metal and contains no stabilizers.

보호자 정보

​세보플루란​은 수술이나 진단 절차 중 수의사가 사용하는 전문 마취 가스입니다.

  • ​빠른 작용​: 반려동물이 매우 빠르고 부드럽게 잠들 수 있게 해주며, 특히 스트레스를 받거나 다루기 힘든 반려동물에게 큰 도움이 됩니다.
  • ​빠른 회복​: 가스 공급을 중단하면 체내에서 빠르게 빠져나가기 때문에, 예전 마취제들보다 훨씬 일찍 깨어나고 일어서며 의식을 회복할 수 있습니다.
  • ​안전성​: 일반적으로 매우 안전하며 심혈관계에 무리를 덜 주어 노령견/묘, 아주 어린 반려동물 또는 특수 동물에게 우선적으로 선택되는 마취제입니다.
  • ​마취 후 주의사항​: 집에 돌아온 후에도 짧은 시간 동안 약간 몽롱하거나 비틀거릴 수 있습니다. 완전히 정상으로 돌아올 때까지 안전하고 조용하며 따뜻한 환경에 머물게 해주세요.

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