Sevoran

Sevorane is a drug used for inhalation anesthesia. Let's consider its pharmacotherapeutic properties and the degree of impact on the central nervous system.

Sevoran contains the active component sevoflurane. This substance has anesthetic properties, so it is used to perform inhalation anesthesia. This method of administering the drug ensures that the patient loses consciousness in a very short time and recovers quickly after the procedure. When administered, the anesthesia causes minor agitation and mild irritation of the respiratory tract mucosa. It does not provoke strong secretion in the tracheobronchial tree and does not stimulate the nervous system.

The drug suppresses respiratory functions and reduces arterial pressure. The severity of these reactions depends entirely on the dose of the drug. Anesthesia does not reduce reactions to carbon dioxide and does not affect intracranial pressure, kidneys or liver.

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Indications Sevorana

Sevoran is used as an inhalation anesthetic. Indications for its use are water and maintenance general anesthesia for adults and children during surgical operations, both in hospital and outpatient settings. The medication is intended for use only by anesthesiologists.

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Release form

The drug is available in liquid form. Sevorane is available as a liquid for inhalation in dark polymer or glass bottles. The drug is available in 100 and 250 ml. Each bottle contains 100% sevoflurane.

Pharmacodynamics

The drug is used for induction of anesthesia, providing rapid loss of consciousness and rapid recovery after the effect of anesthesia. Pharmacodynamics is accompanied by minimal excitation and irritation of the upper respiratory tract. Suppression of respiratory function and reduction of arterial pressure have dose-dependent values. According to clinical studies, the threshold level of sevoflurane, which causes arrhythmia under the influence of adrenaline, is completely comparable with the dosage of isoflurane and exceeds the threshold values of halothane.

The active substance of the drug is characterized by minimal impact on intracranial pressure and absence of reactions to CO2 _. It does not have a clinically significant effect on liver and kidney function, does not provoke aggravation of renal or hepatic failure. Even prolonged anesthesia with Sevoran does not affect the concentration function of the kidneys.

Pharmacokinetics

Sevoflurane has low solubility in blood, which ensures a rapid increase in alveolar concentration when administered in general anesthesia and rapid recovery after inhalation is stopped. Pharmacokinetics of the drug indicate that the ratio of alveolar concentration and values in the inhaled mixture in the accumulation phase half an hour after inhalation is about 0.85. In the elimination phase after 5 minutes, these concentrations reach 0.15.

The active component of the anesthesia is quickly and completely eliminated from the lungs, minimizing the metabolism of the drug. At the same time, less than 5% of the absorbed dose is metabolized by cytochrome P450 (CYP 2E1). The level of fluoride ion concentration depends entirely on the duration of anesthesia, the composition of the anesthesia mixture, and the concentration of Sevoran. Barbiturates do not cause defluorination of the active substance.

Dosing and administration

The instructions for the drug indicate its method of use and dosage. Sevoran is indicated for premedication purposes, but only by inhalation. The dosage is calculated based on age, body weight, gender, planned duration and complexity of surgical manipulations. Anesthesia is administered using a special inhalation vaporizer, the active substance is supplied with oxygen or in a mixture of oxygen and nitric oxide.

With an active component concentration of up to 8%, general anesthesia is achieved in less than 2 minutes. But there are a number of exceptions, these are elderly patients, since their drug metabolism is much slower. To maintain the effect obtained, a concentration of 0.5-3% is used.

The effectiveness of Sevoran is determined depending on the MAC value. There are approximate MAC values of the drug for patients of different ages, let's consider them:

• Full-term newborns have 3.3% oxygen.
• 1-6 months – in 3% oxygen.
• up to 3 years – in oxygen 2.8%, in a mixture of N2O 60% and O2 40% – 2%.
• 3-12 years – 2.5% oxygen.
• 25 years – in oxygen 2.6%, in a mixture of N2O 65% and O2 35% – 1.4%.
• 40 years – in oxygen 2.1%, in a mixture of N2O 65% and O2 35% – 1.1%.
• 60 years – in oxygen 1.7%, in a mixture of N2O 65% and O2 35% – 0.9%.
• 80 years – in oxygen 1.4%, in a mixture of N2O 65% and O2 35% – 0.7%.

When choosing a dosage, it is necessary to take into account that MAC is not determined in premature newborns. When using anesthesia in pediatrics for children aged 1-3 years, a mixture of N ₂ O and O ₂ is used in a ratio of 60:40. Recovery from anesthesia with Sevoran is much faster than when using similar inhalation anesthetics.

Use Sevorana during pregnancy

The possibility of using Sevoran during pregnancy should be determined by an anesthesiologist and a gynecologist. According to clinical studies, the drug does not affect the reproductive system and does not have a damaging effect on the fetus. The drug is safe to use for general anesthesia during cesarean section. With special caution, this anesthesia is prescribed to women who are breastfeeding.

Contraindications

Sevoran is not recommended for use in case of hypersensitivity to its components. Contraindications for use concern patients with elevated body temperature, various kidney disorders and craniocerebral hypertension.

Side effects Sevorana

The risk of developing side effects of Sevoran depends entirely on the dosage. The drug can cause depression of the respiratory center and cardiovascular system. At the stage of recovery from general anesthesia, for a short time, the following side effects may be observed:

• Nausea and vomiting.
• Increased drowsiness.
• Blood pressure instability.
• Cough and chills.
• Bradycardia.
• Tachycardia.
• Headaches and dizziness.
• Agitation.
• Respiratory disorders of varying severity.
• Increased salivation.

In addition to the reactions described above, the following side effects are also possible: postoperative hepatitis, convulsions, various allergic reactions of the skin and respiratory system, dystonia in children, malignant hyperthermia, frequent mood swings, leukocytosis, increased blood sugar levels.

Overdose

Incorrect calculation of anesthesia doses can lead to serious and even irreversible changes in the human body. Overdose is manifested by more pronounced side effects. The following measures are indicated for recovery: stop using the drug, provide oxygen to the lungs by any available means, ensure normal functioning of the cardiovascular system.

Interactions with other drugs

The safety and effectiveness of interaction of Sevoran with other drugs has clinical confirmation. Most often, the drug is used simultaneously with muscle relaxants, antimicrobial agents, including aminoglycosides, hormones and their synthetic analogues, blood products and cardiovascular agents, including adrenaline, that is, drugs that affect the function of the central and autonomic nervous system.

Sevoflurane has the ability to displace drugs with serum and tissue proteins. Anesthesia can be combined with opioids, barbiturates, benzodiazepines.

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Storage conditions

According to storage conditions, vials with the drug must be kept in a dark, dry and cool place, inaccessible to children. The storage temperature should be within 25°C.

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Shelf life

Sevoran must be used within 36 months from the date of its manufacture. The expiration date is indicated on the packaging of the drug and after its expiration, the use of the medicine is contraindicated.