Home > Medical Reference > Encyclopedia (English)

Please install flash player to see this video.

Hospital Virtual Tour

Related Content

Pronunciation:

(EN floo rane)

U.S. Brand Names:

Ethrane®

Generic Available:

Canadian Brand Names:

Ethrane®

Use:

Maintenance of general anesthesia

Contraindications:

Hypersensitivity to enflurane or any component of the formulation; known or suspected history of malignant hyperthermia

Warnings/Precautions:

Decrease in blood pressure is dose dependent, primarily due to peripheral vasodilation. Enflurane does not depress cardiac conduction nor does it sensitize the myocardium to catecholamine-induced arrhythmias like halothane. Respiration is depressed with a PaCO2 of 55 mm Hg at 1 MAC. Hypoxic pulmonary vasoconstriction is blunted. EEG seizure complexes have been seen with higher doses especially associated with hypocarbia; therefore, it is not recommended for use in patients with seizure history. Hypoxia induced increase in ventilation is abolished at low enflurane concentration. Enflurane dilates the cerebral vasculature and may, in certain conditions, increase intracranial pressure. Renal, splenic, and hepatic blood flow are reduced. Enflurane is a trigger of malignant hyperthermia.

Adverse Reactions:

Frequency not defined.

Cardiovascular: Hypotension, myocardial depression, tachycardia

Central nervous system: Seizure activity during or after emergence from enflurane anesthesia; motor activity and/or seizure, especially with hypocapnia

Gastrointestinal: Nausea, vomiting

Hepatic: Hepatic injury, hepatic failure (rare)

Renal: Renal dysfunction, nephrotoxicity

Respiratory: Respiratory depression/arrest, hypoxemia, breath holding, cough

Miscellaneous: Shivering

Drug Interactions:

Substrate of CYP2E1 (major)

Aminoglycosides: Concomitant use may increase risk of nephrotoxicity.

Antihypertensives: Excessive hypotension may occur with combined use.

Benzodiazepines, opioids: Concurrent use of opioids and/or benzodiazepines decreases the MAC of enflurane.

CYP2E1 inhibitors: May increase the levels/effects of enflurane. Example inhibitors include disulfiram, isoniazid, and miconazole.

Neuromuscular-blocking agents (nondepolarizing): Enflurane may potentiate the action of nondepolarizing, neuromuscular-blocking agents.

Pharmacodynamics/Kinetics:

Onset of action: 7-10 minutes

Duration: Emergence time: Depends on blood concentration when enflurane is discontinued

Metabolism: Hepatic (2% to 10%)

Excretion: Exhaled gases

Dosage:

Minimum alveolar concentration (MAC), the concentration at which 50% of patients do not respond to surgical incision, is 1.6% for enflurane. The concentration at which amnesia and loss of awareness occur (MAC - awake) is 0.4%. Surgical levels of anesthesia are achieved with concentrations between 0.5% to 3%. MAC is reduced in the elderly.

Administration:

Via enflurane-specific calibrated vaporizers

Monitoring Parameters:

Blood pressure, heart rate and rhythm, temperature, oxygen saturation, end-tidal CO2 and end-tidal enflurane concentrations should be monitored prior to and throughout anesthesia

Anesthesia and Critical Care Concerns/Other Considerations:

Use of enflurane for induction of general anesthesia is not recommended due to its airway irritant properties and unpleasant odor which may cause breath holding and coughing.

Dental Health: Effects on Dental Treatment:

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

No information available to require special precautions

Dosage Forms:

Liquid, for inhalation: >99.9% (125 mL [DSC], 250 mL)

International Brand Names:

Alyrane® (AU, BE, GB, IL, LU, ZA); Efrane® (DK); Enflurane® (GB); Enflurano® (BR, CL); Enfluthane® (BR); Enforan® (AR); Enfran® (MX); Enlirane® (MX); Ethrane® (AT, AU, BE, CA, DE, HK, ID, IL, IT, LU, MX, RO, TR, ZA); Inhelthran® (AR)

References

Campagna JA, Miller KW, and Forman SA, "Mechanisms of Action of Inhaled Anesthetics,"N Engl J Med, 2003, 348(21):2110-24.

Cousins MJ, Greenstein LR, Hitt BA, et al, "Metabolism and Renal Effects of Enflurane in Man,"Anesthesiology, 1976, 44(1):44-53.

Gion H and Saidman LJ, "The Minimum Alveolar Concentration of Enflurane in Man,"Anesthesiology, 1971, 35(4):361-4.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.