Sevoflurane Dosage

Applies to the following strengths: 100%

Usual Adult Dose for Anesthesia

Surgical levels of anesthesia can usually be achieved with inspired concentrations of 0.5 to 3% sevoflurane with or without the concomitant use of nitrous oxide.

Average MAC (minimum alveolar concentration) with sevoflurane in oxygen:

25 year old: 2.6%
40 year old: 2.1%
60 year old: 1.7%

Average MAC with sevoflurane in 65% N2O/35% O2:

25 year old: 1.4%
40 year old: 1.1%
60 year old: 0.9%

Comments:

Know the concentration delivered from a vaporizer during anesthesia; use a vaporizer calibrated specifically for sevoflurane.
Individualize and titrate dose to the desired effect according to the patient's age and clinical status.
Premedicate according to patient needs, at the discretion of the anesthesiologist.
Suitable for mask induction as it has a nonpungent odor and does not cause respiratory irritability.

Use: Induction and maintenance of general anesthesia for inpatient and outpatient surgery

Usual Geriatric Dose for Anesthesia

80 year old: 1.4%

Average MAC with sevoflurane in 65% N2O/35% O2:

80 year old: 0.7%

Comments:

MAC decreases with increasing age; the average concentration of sevoflurane to achieve MAC in an 80 year old is approximately 50% of that required in a 20 year old.
Know the concentration delivered from a vaporizer during anesthesia; use a vaporizer calibrated specifically for sevoflurane.
Individualize and titrate dose to the desired effect according to the patient's age and clinical status.
Premedicate according to patient needs, at the discretion of the anesthesiologist.
Suitable for mask induction as it has a nonpungent odor and does not cause respiratory irritability.

Use: Induction and maintenance of general anesthesia for inpatient and outpatient surgery

Usual Pediatric Dose for Anesthesia

0 to 1 month: 3.3%
1 to less than 6 months: 3%
6 months to less than 3 years: 2.8%
3 to 12 years: 2.5%

Average MAC with sevoflurane in 60% N2O/40% O2:

6 months to less than 3 years: 2%

Comments:

The concentration required for maintenance of general anesthesia is age dependent.
When used in combination with nitrous oxide, reduce the MAC equivalent dose.
MAC in premature infants has not been determined.
Know the concentration delivered from a vaporizer during anesthesia; use a vaporizer calibrated specifically for sevoflurane.
Individualize and titrate dose to the desired effect according to the patient's age and clinical status.
Premedicate according to patient needs, at the discretion of the anesthesiologist.
Suitable for mask induction as it has a nonpungent odor and does not cause respiratory irritability.

Use: Induction and maintenance of general anesthesia for inpatient and outpatient surgery

Renal Dose Adjustments

Use with caution.

Liver Dose Adjustments

Use with caution.

Dose Adjustments

The anesthetic requirement for sevoflurane is decreased when administered in combination with nitrous oxide.
Using 50% N2O, the MAC equivalent dose requirement is reduced approximately 50% in adults, and approximately 25% in pediatric patients.

Dialysis

Data not available

Other Comments

Administration advice:

Administer only by persons trained in the administration of general anesthesia.
Facilities for maintenance of a patent airway, artificial ventilation, oxygen enrichment, and circulatory resuscitation must be immediately available.
Since level of anesthesia may be altered rapidly, only vaporizers producing predictable concentrations of sevoflurane should be used.

General:

Replace CO2 absorbent for suspicion of desiccation.

Occupational Caution:

There is no specific work exposure limit established for sevoflurane.
The National Institute for Occupational Safety and Health recommends an 8 hour time-weighted average limit of 2 ppm for halogenated anesthetic agents in general (0.5 ppm when coupled with exposure to N2O)