Isoflurane has a blood:gas partition coefficient substantially lower than that of halothane or enflurane (Table 13-1). Consequently, induction with isoflurane and recovery from isoflurane are relatively rapid. More than 99% of inhaled isoflurane is excreted unchanged via the lungs. Isoflurane does not appear to be a mutagen, teratogen, or carcinogen.
CLINICAL USE Isoflurane is typically used for maintenance of anesthesia after induction with other agents because of its pungent odor, but induction of anesthesia can be achieved in <10 minutes with an inhaled concentration of 3% isoflurane in O2; this concentration is reduced to 1-2% for maintenance of anesthesia. Use of drugs (e.g., opioids, nitrous oxide) reduces the concentration of isoflurane required for surgical anesthesia.
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