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British Journal of Anaesthesia, 2000, Vol. 85, No. 2 305-307
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Brief Communication

Which is most pungent: isoflurane, sevoflurane or desflurane?

M. F. TerRiet, G. J. A. DeSouza, J. S. Jacobs, D. Young, M. C. Lewis, C. Herrington and M. I. Gold

Veterans Affairs Medical Center, Anesthesiology Service, University of Miami School of Medicine, Department of Anesthesiology, Miami, FL, USA*Corresponding author: VA Medical Center (139), 1201 NW 16th Street, Miami, FL 33125, USA

Abstract

We compared the pungency and tolerability of three inhaled anaesthetics in a randomized, double-blind study. Eighty-one unpremedicated patients (n=27, each group) inhaled 2 MAC of isoflurane (2.3%), desflurane (12%) or sevoflurane (4%) for 60 s from an anaesthetic breathing circuit via a mask. Two blinded observers recorded coughing, complaints of burning and irritation, and how long the inhalation was tolerated. One sevoflurane patient coughed, but completed the study period, whereas 11 isoflurane patients and 20 desflurane patients coughed, objected verbally or removed the mask forcefully. All sevoflurane, 20 isoflurane and seven desflurane patients completed the study period (average 60, 49 and 33 s, respectively, P<0.05). The irritability grading was: desflurane > isoflurane > sevoflurane (P<0.05). Sevoflurane is the least irritating agent for inhalation at 2 MAC concentration.

Br J Anaesth 2000; 85: 305–7


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