ANZCA Bulletin June 2011 - Australian and New Zealand College of ...

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References: 1. Dupont J, Tavernier B, Ghosez Y, et al. Br J Anaesth. 1999;82:355-9. 2. Dexter F, Bayman
EO, Epstein RH. Anesth Analg. 2010;110:570-80. 3. Mahmoud NA, Rose DJA, Laurence AS. Anaesthesia.
2001;56:171-82. 4. Bilotta F, Doronzio A, Cuzzone V, et al. for PINOCCHIO Study Group. J Neurosurg
Anesthesiol. 2009;21:207-13. 5. Caverni V, Rosa G, Pinto G, et al. J Craniofacial Surg. 2005;16(4):531-
6. 6. Juvin P, Servin F, Giraud O, Desmonts JM. Anesth Analg. 1997;85:647-51. 7. La Colla L, Albertin
A, et al. Br J Anaesth. 2007;99:353-8. 8. McKay RE, Large MJC, Balea MC, McKay WR. Anesth Analg.
2005;100:697-700. 9. McKay RE, Malhotra A, Cakmakkaya OS, et al. Br J Anaesth. 2010;104:175-82.
10. Eger EI II. Anesth Rev. 1993;20(3):87-92. 11. Avramov MN, Griffin JD, White PF. Anesth Analg.
1998;87:666-70. 12. Bennett JA, Mahadeviah A, Stewart J, et al. J Clin Anesth. 1995;7:288-91.
13. Beaussier M, Paugam C, Deriaz H, et al. Acta Anaesthesiol Scand. 2000;44:1154-59. 14. Eger
EI II, Eisenkraft JB, Weiskopf RB. The Pharmacology of Inhaled Anesthetics. 2nd ed. Edmund I. Eger II,
MD: 2003:43. 15. Beaussier M, Decorps A, Tilleul P, et al. Can J Anesth. 2002;49:339-46 16. Gupta
A, Stierer T, et al. Anesth Analg. 2004;98:632-41. 17. Fanelli G, Berti M, Casati A. Eur J Anaesthesiol.
2006;23(10):861-68.
ABRIDGED PRODUCT INFORMATION
SUPRANE: Registered Trade Mark
NAME OF DRUG: Desflurane USP
INDICATIONS: SUPRANE is indicated as an inhalation agent for
maintenance of anaesthesia. SUPRANE is not recommended
for mask induction of anaesthesia because of a high incidence of
moderate to severe upper airway adverse events.
CONTRAINDICATIONS: SUPRANE should not be used for patients
in whom general anaesthesia is contraindicated. SUPRANE is also
contraindicated in patients with known sensitivity to halogenated
agents and in patients with known or genetic susceptibility to
malignant hyperthermia.
SUPRANE is contraindicated in patients with a history of malignant
hyperthermia, or in whom liver dysfunction, jaundice or unexplained
fever, leucocytosis, or eosinophilia has occurred after a previous
halogenated anaesthetic administration.
PRECAUTIONS: SUPRANE, as with other halogenated anaesthetics,
has been reported to interact with dry carbon dioxide absorbents
to form carbon monoxide. When the anaesthetist has any doubt
regarding the moisture content of the CO 2
absorbent, or suspects that
the CO 2
absorbent may be desiccated, it should be replaced before
administration of SUPRANE.
SUPRANE should only be administered by persons trained in the
administration of general anaesthesia using a vaporiser specifically
designed and designated for use with SUPRANE. Facilities for
maintenance of a patent airway, artificial ventilation, oxygen enrichment
and circulatory resuscitation must be immediately available.
Hypotension and respiratory depression increase as anaesthesia is
deepened.
SUPRANE is not recommended for use as an inhalation induction
agent in adults and children because of the frequent occurrence
of cough, breath holding, apnoea, laryngospasm and increased
secretions.
ADVERSE REACTIONS: As with all potent inhaled anaesthetics,
SUPRANE may cause dose-dependent hypotension. A dosedependent
respiratory depression
is also observed. Most other adverse events are mild
and transient.
Desflurane is not recommended for use as an inhalational induction
agent because of the frequent occurrence of cough, breath holding,
apnoea, laryngospasm and increased secretions.
Nausea and vomiting have been observed in the postoperative
period, common sequelae of surgery and general anaesthesia, which
may be due to inhalational anaesthetic, other agents administered
intraoperatively or post-operatively and to the patient’s response to
the surgical procedure.
DOSAGE AND ADMINISTRATION: SUPRANE is administered by
inhalation. The concentration of
SUPRANE should be delivered from a vaporiser specifically designed
and designated for use with SUPRANE.
Premedication: The premedication should be chosen to suit the
individual requirements of the patient. Studies to date have not
shown an effect of premedication on respiratory tract reactions
associated with inhalational induction of anaesthesia.
Dosage: The minimum alveolar concentration (MAC)
of SUPRANE is age-specific and has been determined
as listed below:
Effect of Age on SUPRANE MAC
AGE
100% OXYGEN
(end-tidal %)
60% NITROUS OXIDE/
40% OXYGEN (end-tidal %)
0 – 1 year 8.95 – 10.65 5.75 – 7.75*
1 – 12 years 7.20 – 9.40 5.75 – 7.00**
18 – 30 years 6.35 – 7.25 3.75 – 4.25
30 – 65 years 5.75 – 6.25 1.75 – 3.25
Over 65 years 5.17 +0.6% 1.67+0.4%
*3 – 12 months **1 – 5 Years
PRESENTATION: SUPRANE is supplied in 240mL amber coloured
glass bottles.
Please review Approved Product Information before prescribing.
Product Information is available from Baxter Medical Information on
1300 302409 or onecall@baxter.com.
NAME AND ADDRESS OF THE SPONSOR
Baxter Healthcare Pty Ltd
1 Baxter Drive, Old Toongabbie, N.S.W., Australia
DATE OF TGA APPROVAL: 21 November 2006
Date of most recent amendment: 1 July 2009
SUPRANE is a registered trade mark of Baxter International Inc.
PBS Information: These products are not listed on the PBS
SUPRANE is a trademark of Baxter International Inc. For further information, please contact your local Baxter Representative.
Please review full Approved Product Information before prescribing. Product Information is
available on request from Baxter Medical Information on 1300 302 409.
Baxter Healthcare Pty Ltd
1 Baxter Drive, Old Toongabbie
NSW 2146, Australia
Tel: +61 2 9848 1111
Fax: +61 2 9848 1123
www.baxterhealthcare.com.au
22 ANZCA Bulletin June 2011
Baxter Healthcare Ltd
33 Vestey Drive, Mount Wellington
Auckland 1006, New Zealand
Tel: +64 9 574 2400
Fax: + 64 (0) 800 229 329
www.baxter.co.nz
SUPRANE is a trademark of Baxter International Inc.
Medical Information:
1300 302 409 or email onecall@baxter.com
PA029MD/2011