地氟醚
地氟醚 (Desflurane) 是一種鹵素類揮發性吸入麻醉劑，化學結構與異氟醚 (Isoflurane) 極為相似。其最大臨床優勢在於**極快的麻醉誘導與甦醒速度**。由於其沸點接近室溫，必須使用專用的電加熱加壓揮發罐。它具有刺激性氣味，不適合用於面罩誘導。
作用機制: 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.*
各物種劑量
- 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
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Hypersensitivity to desflurane or other halogenated anesthetic agents
- History of or predilection towards malignant hyperthermia
不良反應
- 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
藥物相互作用
- 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.
監測
- 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
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 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。