1-5 6-9
All the benefi ts of Suprane for your adult Laryngeal Mask Airway patients
PROCEDURE
LAPAROSCOPIC CHOLECYSTECTOMY
HERNIA KNEE ARTHROSCOPY VARICOSE VEIN
DESTINATION STATUS PACU
DISCHARGE OR1
PACU LASER PROSTATECTOMY OR2
ON TIME ON TIME ON TIME ON TIME ON TIME
Predictable performance1-10
1. Suprane Summary of Product Characteristics, UK November 2011. 2. Tec-6 Plus Vaporiser Operation and Maintenance Manual, 2001. 3. D-Vapor Vaporiser IFU, 2005. 4. Avramov et al Anesth Analg 1998;87:666–70 5. Bennett J A et al J Clin Anaesth 1995;7:288–291. 6. Agoliati A et al Anesth Analg 2010;110:1433–9. 7. Dexter F Anesth analg 2010;110:570–80. 8. McKay R E et al BJA 2010;104(2):175–82. 9. Juvin P et al Anesth Analg 2000;91:714–9. 10. Fanelli G Eur J Anaesthesiol 2006;23(10):862–868.
SUPRANE® (desfl urane) PRESCRIBING INFORMATION. Name
and composition: Desfl urane, supplied as a volatile liquid, pure drug substance. Indications: Inhalation agent for induction and/or maintenance of anaesthesia in adults, maintenance of anaesthesia in paediatrics. Dosage and Route: See SPC for full details. Administration by inhalation using vapouriser specifi cally designed for use with desfl urane and dose individualised based on patient’s response. MAC decreases with increasing age. Induction: Inspired concentrations of 4–11% usually produces surgical anaesthesia in 2–4 minutes. Not for induction in paediatrics. Maintenance: 2–6% with concomitant nitrous oxide or 2.5–8.5% in oxygen or enriched air. 5.2–10% with or without nitrous oxide in paediatrics. Not for use in non-intubated children under 6 years old. Concentrations of 1–4% have been used successfully in chronic renal/hepatic impairment and renal transplant. Side effects: May cause dose dependant cardio-respiratory depression. Nausea and vomiting has been reported postoperatively – may be due to a range of factors and common following surgery under general anaesthesia. Common (≥1/100 – <1/10) Pharyngitis, breath holding, headache, conjunctivitis, nodal arrhythmia, bradycardia, tachycardia, hypertension, apnea, cough, laryngospasm, salivary hypersecretion, increased creatinine phosphokinase, ECG abnormal. Precautions: Only to be administered by people trained in administration of
general anaesthesia with appropriate emergency measures available. Monitor blood pressure and heart rate as part of evaluation of the depth of anaesthesia. Caution in use with LMA or face mask in children under 6 years. May trigger malignant hyperthermia. Inhaled anaesthetics have been associated with increases in serum potassium. Prompt and vigorous treatment for hyperkalaemia and arrhythmias recommended. Disruption of hepatic function, icterus and fatal liver necrosis have been reported with halogenated anaesthetics. May increase CSF pressure but attention to maintain CPP. Rapid increase in end-tidal concentration may increase heart rate and blood pressure. Hypotension and respiratory depression increases as anaesthesia deepens. Use in hypovolaemia, hypotension and debilitated patients has not been investigated, a lower concentration is recommended. Carbon dioxide absorbers should not dry out. Appropriate analgesia should be administered at the end of surgery or early in PACU. Caution with repeated anaesthesia in a short period of time. Desfl urane has been associated with some glucose elevation intra-operatively. Safety of desfl urane has not been established in obstetric procedures. Contra-indications: Not to be used if general anaesthesia in contra- indicated, known hypersensitivity to halogenated agents or known susceptibility to malignant hyperthermia. Not for induction in patients at risk of coronary artery disease or where increases in heart rate or
blood pressure are undesirable. Patients with coronary artery disease, maintain normal haemodynamics to avoid myocardial ischaemia. Desfl urane is not indicated for use during pregnancy and lactation. Interactions: MAC reduced by concomitant N2O administration. Concomitant administration of opioids or benzodiazepines show a marked reduction in MAC. Neuromuscular blocks are potentiated by desfl urane. Overdose: Discontinue desfl urane, establish clear airway and initiate assisted/controlled ventilation with pure oxygen. Support and maintain adequate haemodynamics. Legal category: POM Basic NHS price: £63.31 per 240ml bottle Market Authorisation number and holder: PL 0116/0327 – Baxter Healthcare Limited, Caxton Way, Thetford, Norfolk. IP24 3SE. Date of Preparation: March 2012.
ADVERSE EVENTS SHOULD BE REPORTED. Reporting forms and information can be found at
www.mhra.gov.uk/yellowcard Any adverse events relating to Baxter
products can also be reported direct to Baxter Pharmacovigilance on 01635 206360, or by e-mail to
vigilanceuk@baxter.com
UK/SUP/13-002 Date of preparation: January 2013.
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