Inhalation agent for induction of anesth for inpatient & outpatient surgery in adults. Maintenance of anesth for inpatient & outpatient surgery in adults & in ped patients.
Administer by inhalation using specific vaporizer. Administration must be individualized based on patient's response. Whether or not to premedicate & the choice of premedication(s) must be individualized. Adult Induction Frequent starting conc is 3%; increased in 0.5-1% increments every 2-3 breaths. After induction w/ IV drug (eg, thiopental or propofol), Suprane can be started at approx 0.5-1 MAC in O2 or N2O/O2 carrier gas. Maintenance 2.5-8.5% w/ or w/o concomitant N2O. Ped patient Maintenance of anesth after induction w/ agents other than Suprane, & tracheal intubation 5.2-10% w/ or w/o concomitant N2O.
View Suprane overdosage for action to be taken in the event of an overdose.
Contraindications
Hypersensitivity to Suprane or to other halogenated agents. Known or suspected genetic susceptibility to malignant hyperthermia. Patients in whom general anesth is contraindicated. Induction of anesth in ped patients. Patients w/ history of moderate to severe hepatic dysfunction following anesth w/ Suprane or other halogenated agents & not otherwise explained.
Should not be used as sole agent for anesth induction in patients w/ CAD or patients where increases in heart rate or BP are undesirable. May produce dose-dependent increase in CSF pressure when administered to patients w/ intracranial space occupying lesions. May trigger malignant hyperthermia in susceptible individuals. Associated w/ rare increases in serum K that have resulted in cardiac arrhythmias & death in ped patients during post-op period. Not approved for maintenance of anesth in non-intubated childn. Increased risk of adverse resp reaction in childn ≤6 yr who are under anesth maintenance w/ Suprane delivered via laryngeal mask airway (especially w/ removal of laryngeal mask airway under deep anesth). Increased risk of airway narrowing & increases in airway resistance in childn under anesth maintenance w/ asthma or history of recent upper airway infection. Reports of QTc prolongation associated w/ Torsade de pointes; disruption of hepatic function, icterus, & fatal liver necrosis. May cause sensitivity hepatitis in patients who have been sensitized by previous exposure to halogenated anesth. Risk of ped neurotoxicity w/ repeated or prolonged exposures to anesth agents early in life. Can react w/ desiccated CO2 absorbents producing carbon monoxide that may result in elevated levels of carboxyhemoglobin in some patients. Transient elevations in glucose & WBC may occur. Emergence from anesth in childn may evoke a brief state of agitation. Pregnancy & lactation. Elderly.
Decreased MAC w/ benzodiazepines & opioids; N2O. Reduced ED95 of succinylcholine, atracurium & pancuronium at anesth conc of desflurane at equilibrium.
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