Anaes Vivas · Volatile & inhalational agents
Data viva — the desflurane sympathetic surge and greenhouse-gas comparison
A Final data viva — read the neurocirculatory-activation line graph (tachycardia/hypertension on rapid desflurane increase) and the greenhouse-gas bar chart; explain the mechanism and mitigation of the surge and the environmental case for and against desflurane.
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A two-panel figure. Left panel: a line graph of blood pressure and heart rate against time, showing a sharp transient spike in both traces at moment inspired desflurane concentration is rapidly increased, followed by settling back towards baseline. Right panel: a bar chart comparing the three volatiles on atmospheric lifetime and carbon-dioxide equivalents per MAC-hour — desflurane (lifetime about 12 to 14 years, about 73 kg CO2-equiv/MAC-h), isoflurane (lifetime about 3 years), sevoflurane (lifetime about 1 to 2 years, about 1.6 kg CO2-equiv/MAC-h). Interpret the left panel, then interpret the right panel, and discuss the clinical and environmental trade-off.[1][2]
References5ShowHide
- [1]Muzi M, et al. Desflurane-mediated neurocirculatory activation in humans. Effects of concentration and rate of change on responses. Anesthesiology, 1996.PMID 8623996
- [2]Tamura T, et al. Environmental and clinical rationale for the use of desflurane: a review of the literature. Journal of Anesthesia, 2026.PMID 42081124
- [3]Somnuke P, et al. Effect of desflurane versus propofol on perioperative neurocognitive disorders in older adults undergoing major urological surgery: a randomized trial. BMC Geriatrics, 2026.PMID 42321629
- [4]Yonker-Sell AE, et al. Alfentanil modifies the neurocirculatory responses to desflurane. Anesth Analg, 1996.PMID 8712395
- [5]Mizutani K, et al. Banning desflurane: Comments on the article, "Environmental and clinical rationale for the use of desflurane: a review of the literature" by Tamura et al. Journal of Anesthesia, 2026.PMID 42319476