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European Journal of Anaesthesiology Oct 2022Potent inhaled anaesthetics are halogenated hydrocarbons with a large global warming effect. The use of fluorinated hydrocarbons (most are not anaesthetics) are being... (Review)
Review
Potent inhaled anaesthetics are halogenated hydrocarbons with a large global warming effect. The use of fluorinated hydrocarbons (most are not anaesthetics) are being restricted but volatile anaesthetics have been exempted from legislation, until now: the EU has formulated a proposal to ban or at least severely restrict the use of desflurane starting January 2026. This narrative review addresses the implications of a politics-driven decision - without prior consultation with major stakeholders, such as the European Society of Anaesthesiology and Intensive Care (ESAIC) - on daily anaesthesia practice and reviews the potential scientific arguments that would support stopping the routine use of desflurane in anaesthetic practice. Of note, banning or severely restricting the use of one anaesthetic agent should not distract the user from sensible interventions like reducing fresh gas flows and developing technology to capture and recycle or destroy the wasted potent inhaled anaesthetics that we will continue to use. We call to join efforts to minimise our professional environmental footprint.
Topics: Anesthesia; Anesthesiology; Anesthetics, Inhalation; Desflurane; Humans; Isoflurane
PubMed: 36036420
DOI: 10.1097/EJA.0000000000001739 -
Anesthesia and Analgesia Mar 2021
Topics: Anesthetics, Inhalation; Desflurane; Isoflurane
PubMed: 33591099
DOI: 10.1213/ANE.0000000000005319 -
Journal of Cardiovascular Pharmacology Sep 2023Coronary heart disease is an affliction that is common and has an adverse effect on patients' quality of life and survival while also raising the risk of intraoperative... (Review)
Review
Coronary heart disease is an affliction that is common and has an adverse effect on patients' quality of life and survival while also raising the risk of intraoperative anesthesia. Mitochondria are the organelles most closely associated with the pathogenesis, development, and prognosis of coronary heart disease. Ion abnormalities, an acidic environment, the production of reactive oxygen species, and other changes during abnormal myocardial metabolism cause the opening of mitochondrial permeability transition pores, which disrupts electron transport, impairs mitochondrial function, and even causes cell death. Differences in reliability and cost-effectiveness between desflurane and other volatile anesthetics are minor, but desflurane has shown better myocardial protective benefits in the surgical management of patients with coronary artery disease. The results of myocardial protection by desflurane are briefly summarized in this review, and biological functions of the mitochondrial permeability transition pore, mitochondrial electron transport chain, reactive oxygen species, adenosine triphosphate-dependent potassium channels, G protein-coupled receptors, and protein kinase C are discussed in relation to the protective mechanism of desflurane. This article also discusses the effects of desflurane on patient hemodynamics, myocardial function, and postoperative parameters during coronary artery bypass grafting. Although there are limited and insufficient clinical investigations, they do highlight the possible advantages of desflurane and offer additional suggestions for patients.
Topics: Humans; Desflurane; Isoflurane; Anesthetics, Inhalation; Reactive Oxygen Species; Quality of Life; Reproducibility of Results; Coronary Disease
PubMed: 37405905
DOI: 10.1097/FJC.0000000000001448 -
Anaesthesia Mar 2024
Topics: Humans; Desflurane; Anesthetics, Inhalation; Isoflurane
PubMed: 38207006
DOI: 10.1111/anae.16219 -
British Journal of Anaesthesia Dec 2020
Topics: Anesthetics, Inhalation; Desflurane; Perfusion Index; Sevoflurane; Walking
PubMed: 33039121
DOI: 10.1016/j.bja.2020.09.013 -
The Western Journal of Medicine Jan 1995
Review
Topics: Anesthetics, Inhalation; Desflurane; Humans; Isoflurane
PubMed: 7863661
DOI: No ID Found -
Die Pharmazie Apr 2019: We conducted a meta-analysis to evaluate different indexes of the postoperative resuscitation period in elderly patients who received desflurane-remifentanil or... (Comparative Study)
Comparative Study Meta-Analysis Review
: We conducted a meta-analysis to evaluate different indexes of the postoperative resuscitation period in elderly patients who received desflurane-remifentanil or sevoflurane-remifentanil. : A systematic search of the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for randomized controlled trials (RCTs) of elderly patients who received desflurane-remifentanil or sevoflurane-remifentanil was conducted. Extracted data were analysed using RevMan version 5.3. s: Six studies involving 336 patients were included. Results indicated that the time to open eyes, time to extubation and time to orientation were faster in the desflurane group than in the sevoflurane group (<0.05). There was no significant difference in the time of discharging from the recovery room between the desflurane and sevoflurane groups (>0.05). The incidence of vomiting and agitation was lower in the desflurane group than in the sevoflurane group (<0.05). No significant difference of hypotension and hypertension was found (>0.05). : Elderly patients who received desflurane-remifentanil exhibited faster recovery than those who received sevoflurane-remifentanil.
Topics: Aged; Anesthesia Recovery Period; Anesthetics, Inhalation; Desflurane; Humans; Randomized Controlled Trials as Topic; Remifentanil; Sevoflurane; Time Factors
PubMed: 30940302
DOI: 10.1691/ph.2019.8935 -
Korean Journal of Anesthesiology Jun 2019
Topics: Anesthesia; Animals; Desflurane; Hypercapnia; Isoflurane; Rats; Sevoflurane
PubMed: 31161758
DOI: 10.4097/kja.19199 -
British Journal of Anaesthesia Dec 2017Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug... (Review)
Review
Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and paralysis with manageable off-target effects. The availability of these agents at generic prices inhibits commercial interest and this is reflected in the limited number of current anaesthetic drug development projects. Recently, questions around neonatal neurotoxicity, delirium and postoperative cognitive dysfunction have stimulated research to characterise these phenomena and explain them in mechanistic terms. Emergent basic science from these enquiries together with exploration of possible effects of anaesthetic drug choice on patient outcomes from cancer surgery may yield new targets for drug discovery.
Topics: Anesthesiology; Anesthetics, Inhalation; Anesthetics, Intravenous; Desflurane; Humans; Hypnotics and Sedatives; Thiopental
PubMed: 29161390
DOI: 10.1093/bja/aex328 -
Anaesthesia Feb 2014
Topics: Anesthesia, Inhalation; Anesthetics, Inhalation; Desflurane; Equipment Contamination; Equipment Failure; Humans; Isoflurane; Nebulizers and Vaporizers
PubMed: 24443867
DOI: 10.1111/anae.12566