Sevoflurane Dosage

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

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:

• 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

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:

• 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)

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer