Sevoflurane USP Solution for Inhalation

Because clinical experience in administering Sevoflurane USP USP to patients with renal insufficiency (creatinine >1.5 mg/dl) is limited, its safety in these patients has not been established. Sevoflurane USP USP may be associated with glycosuria and proteinuria when used for long procedures at low flow rates. Sevoflurane USP USP may present an increased risk in patients with known sensitivity to volatile halogenated anesthetic agents. Sevoflurane USP USP may cause respiratory depression, which may be augmented by opioid premedication or other agents causing respiratory depression. Reports of QT prolongation have been received. Fatal outcomes of malignant hyperthermia have been reported. Use of inhaled anesthetic agents has been associated with rare increases in serum potassium levels that have resulted in cardiac arrhythmias and death in pediatric patients during the postoperative period. Episodes of severe bradycardia and cardiac arrest, not related to underlying congenital heart disease, have been reported during anesthesia induction with Sevoflurane USP USP in pediatric patients with Down syndrome. During induction, closely monitor heart rate and consider incrementally increasing the inspired Sevoflurane USP USP concentration until a suitable level of anesthesia is achieved. Consider having an anticholinergic and epinephrine available when administering Sevoflurane USP USP for induction in this patient population. During the maintenance of anesthesia, increasing the concentration of Sevoflurane USP USP produces dose dependent decreases in blood pressure. Excessive decreases in blood pressure or respiratory depression may be related to depth of anesthesia and may be corrected by decreasing the inspired concentration of Sevoflurane USP USP. The recovery from general anesthesia should be assessed carefully before a patient is discharged from the post-anesthesia care unit.