Isoflurane: A Widely Used Inhalational Agent for Safe and Controlled General Anesthesia

🧠 Introduction to Isoflurane

Isoflurane is a halogenated ether anesthetic agent introduced in the 1980s. It quickly gained popularity due to its stability, minimal metabolism, and cardiovascular safety. Its non-flammability and predictable anesthetic depth made it superior to older agents like halothane.

⚙️ Mechanism of Action

Isoflurane primarily works by:

Enhancing GABA-A receptor activity → increases chloride influx, causing neuronal inhibition

Inhibiting excitatory NMDA receptors → reduces glutamate transmission

Produces CNS depression leading to unconsciousness, immobility, and amnesia

🩺 Clinical Uses

Isoflurane is used for:

Induction and maintenance of anesthesia (more for maintenance than induction due to pungency)

Long surgeries due to stable hemodynamics

Widely used in both human and veterinary anesthesia

⚠️ Side Effects and Risks

Dose-dependent hypotension (due to vasodilation)

Respiratory depression

May trigger malignant hyperthermia in susceptible patients

Less risk of hepatotoxicity compared to halothane

Pungent odor limits its use for inhalation induction, especially in children

🧪 Pharmacological Properties

MAC (Minimum Alveolar Concentration): ~1.15%

Blood:Gas partition coefficient: 1.4 → moderate induction and recovery speed

Metabolism: <0.2% (minimizing organ toxicity)

🧾 Conclusion

Isoflurane remains a reliable, effective, and widely available anesthetic agent. With a favorable safety profile, minimal metabolism, and stable cardiovascular effects, it continues to be an important choice in anesthesia practice worldwide, despite newer agents like sevoflurane and desflurane offering faster recovery.

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