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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot


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Chirurgia Del Piede 1999 June;23(2):79-84

language: Italian

Sevoflurane and isoflurane for general anesthesia in foot surgery

Napoli V.


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Among the various techniques of anesthesia used in foot surgery, general anesthesia with spontaneous breathing is preferred owing to its simplicity and prompt reversibility. Among the general inhalatory anesthetics used that can influence the progress and results of surgery, the authors examine the use of sevoflurane and isoflurane. Isoflurane, which has been used for many years, has the disadvantage of irritating the airways and provoking cough and spasms if used in high concentrations during induction. On the other hand, it ensures cardiocirculatory stability, excellent myoresolution and rapid elimination through the lungs with minimum metabolic involvement of the liver. Reawakening is prompt as is the recovery of vital relational functions. Sevoflurane has been used more recently in clinical practice. It does not irritate the respiratory mucosa and is elective in children since it has no acrid odour, even at the high concentrations necessary to induce and maintain narcosis. Although it does not result in accumulation owing to its scarce solubility in tissues, its use at high concentrations entails a greater metabolic involvement of the liver and a more protracted elimination with slightly slower reawakening. Good cardiocirculatory stability and myoresolution. Both anesthetic products are useful during foot surgery and the choice should be based on the patient's age and the presence of any limiting organ pathologies.

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