ABSTRACT
Introduction 153 Physical characteristics 153 Effects on vital systems 158
Clinical use 161 References 164
Inhalational anaesthetics are used extensively in paediatric anaesthesia. Four agents are still available, among them the relatively new anaesthetics sevoflurane and desflurane. Because of its safe cardiovascular profile, sevoflurane has progressively replaced halothane for mask induction in children. Halothane serves as a reference to characterise the properties of the new halogenated agents. Because of its low cost and safe cardiovascular profile, isoflurane is still administered by some as a maintenance agent in children; however, its slower elimination rate compared with that of desflurane and sevoflurane makes it less manageable than the other two agents. Sevoflurane and desflurane have now been used for 15 years, so their pharmacodynamic properties and their
desirable and undesirable effects on organ systems are well known. Since it is too irritating for mask induction, desflurane has not had a major impact in paediatric anaesthesia. In contrast, sevoflurane has become the volatile agent of reference in children as it is both well tolerated for induction and a useful agent for maintenance. Its safety profile has justified its use with a large therapeutic range.
