Inhalation agents are anesthetics that you inhale. Inhalation
anesthetics are used to both begin (induce) and maintain
general anesthesia. Induction with inhalation agents
is preferred for small children and adults when it would be difficult to give
anesthetics through a vein (intravenously, IV).
Inhalation anesthetics are often preferred for general anesthesia
because they are easy to give through a face mask, an
endotracheal (ET) tube, or a laryngeal mask airway
(LMA). They also act quickly and wear off relatively quickly. But after they
wear off, inhalation anesthetics do not provide any long-lasting relief from
pain (analgesia).
The most commonly used inhalation agents include:
- Potent inhalation agents,
which provide complete general anesthesia without additional medicines. The
most commonly used potent inhalants include desflurane (Suprane), isoflurane
(Forane), and sevoflurane (Ultane). The potent inhalants are delivered mixed
with oxygen. They may be combined with nitrous oxide to allow the potent agent
to be used at a lower concentration, which decreases undesirable side effects
and risk of complications.
- Nitrous oxide,
which is commonly called "laughing gas." Nitrous oxide is an odorless,
colorless gas that relieves pain and has milder effects that cause
forgetfulness (amnesia) and sleepiness (hypnosis). This is sufficient for many
minor procedures such as dental work, but nitrous oxide must be combined with
other sedatives, analgesics, and anesthetic medicines to provide full general
anesthesia for more painful or extensive procedures. It is given in a mixture
with oxygen.
Anyone receiving inhalant anesthetics for general anesthesia is
closely monitored, because the anesthetics can strongly affect the
central nervous system and cardiovascular system and
significantly affect breathing, heartbeat, blood pressure, and other vital
functions.
Some inhalation agents have an unpleasant odor and may irritate the
respiratory tract. But your anesthetist uses these agents in a skillful manner
and combines them with other agents to avoid airway irritation. Sevoflurane is
less irritating to the airway and is preferred for inducing anesthesia in
children.
All the potent inhalation agents are capable of triggering
malignant hyperthermia (MH), a rare inherited
(genetic) disorder that is potentially fatal.