Posology : מינונים

DOSAGE AND ADMINISTRATION
Sevoflurane should be administered 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. The concentration of sevoflurane being delivered from a vaporizer during anesthesia should be known. This may be accomplished by using a vaporizer calibrated specifically for sevoflurane. The administration of general anesthesia must be individualized based on the patient’s response.

Replacement of Desiccated CO2 Absorbents
When a clinician suspects that the CO2 absorbent may be desiccated, it should be replaced. The exothermic reaction that occurs with sevoflurane and CO2 absorbents is increased when the CO2 absorbent becomes desiccated, such as after an extended period of dry gas flow through the CO2 absorbent canisters (see PRECAUTIONS).

Pre-anesthetic Medication
No specific premedication is either indicated or contraindicated with sevoflurane. The decision as to whether or not to premedicate and the choice of premedication is left to the discretion of the anesthesiologist.

Induction
Sevoflurane has a nonpungent odor and does not cause respiratory irritability; it is suitable for mask induction in pediatrics and adults.

Maintenance
Surgical levels of anesthesia can usually be achieved with concentrations of 0.5-3% sevoflurane with or without the concomitant use of nitrous oxide. Sevoflurane can be administered with any type of anesthesia circuit.

Table 9. MAC Values for Adults and Pediatric Patients According to Age Age of       Sevoflurane in Sevoflurane
Patient         Oxygen       in 65% N O/      2
(years)                               35% O2
0-1 months#           3.3%
1 - < 6 months        3.0%
2.8%             2.0%
6 months- < 3 years
3-12                  2.5%
25                    2.6%             1.4%
40                    2.1%             1.1%
60                   1.7%             0.9%
80                    1.4%              0.7%
# Neonates are full-term gestational age. MAC in premature infants has not been determined.
@ In 1 - < 3 year old pediatric patients, 60% N2O/40% O2 was used.