home→Ulcer→ Features of the use of halothane, side effects and contraindications. Instructions for use ftorotan (ftorotan) Conditions for dispensing from pharmacies

Features of the use of halothane, side effects and contraindications. Instructions for use ftorotan (ftorotan) Conditions for dispensing from pharmacies

Dosage form: Liquid for inhalation. Composition: As active substance - halothane;

excipient- thymol.

Description: Transparent, colorless, heavy, mobile, volatile liquid with an odor reminiscent of chloroform. Pharmacotherapeutic group:Means for inhalation general anesthesia ATX:

N.01.A.B.01 Halothane

N.01.A.B Halogenated hydrocarbons

Pharmacodynamics:Causes a rapid introduction to anesthesia with no or minimal manifestation of the excitation stage. It has an analgesic and muscle relaxant effect (does not create sufficient relaxation of the muscles, and therefore additional use of muscle relaxants is required). Increases the tone of n.vagus, causes bradycardia. Due to the direct negative inotropic action, it reduces myocardial contractility and stroke volume. By increasing the sensitivity of cardiomyocytes to catecholamines, it increases the likelihood of developing arrhythmias. In proportion to the depth of general anesthesia weakens the contractility of the uterus. At a concentration of 0.5 to 3-4 vol.%, the surgical stage of anesthesia is reached in 4-6 minutes, after the end of general anesthesia, awakening occurs in 5-15 minutes. Pharmacokinetics:When inhaled, it is absorbed from the lumen of the alveoli into the bloodstream, the concentration in the alveoli and blood quickly balances. It is distributed in organs with good vascularization (brain, heart, liver), muscles, adipose tissue. Quickly passes histohematic barriers, including blood-brain and placental. After the cessation of entry into the body, the decrease in its concentration in plasma is exponential. It is excreted by the lungs - 60 and 80% unchanged; kidneys - 20% in the form of inactive metabolites.

It is metabolized by oxidation in the liver, the main metabolites are trifluoroacetic acid, chlorides, bromides. It is excreted mainly by the lungs unchanged and in the urine as metabolites. At low oxygen tension, it is metabolized to the free radical chlorotrifluoroethyl, which is able to react with the components of the hepatocyte membrane.

Indications: Introductory and maintenance anesthesia in adults and children. Contraindications:Hypersensitivity, unexplained jaundice, fever or fever after administration of halothane in history; pheochromocytoma, hypercatecholaminemia, arterial hypotension, myasthenia gravis, use of halothane for general anesthesia less than 3 months ago, pregnancy (1 trimester), childbirth and early postpartum period, dental procedures for children and adolescents under 18 years of age outside hospital conditions. Carefully:Reception of cardiac glycosides. The drug is contraindicated in patients with a known or suspected genetic predisposition to malignant hyperthermia. Pregnancy and lactation:Contraindicated in the 1st trimester of pregnancy, during childbirth and in the early postpartum period. After anesthesia, the drug should be discontinued breast-feeding for 24 hours. Dosage and administration:

Suitable for any type of inhalation anesthesia. The correct dose is achieved with a calibration evaporator located outside the closed circulation system (to avoid overdosing).

adults

Induction

For anesthesia at a flow rate of 8 l/min. start with the supply of halothane at a concentration of 0.5 vol.% (with oxygen), then gradually increase the concentration of halothane vapor in the mixture to 0.5 - 3 vol.%. As a maintenance concentration, as a rule, 0.5 - 1.5 vol.% is sufficient for adults.

Children

During induction, children, starting from newborns, require more concentration than adults.

Elderly

Elderly patients require a lower dosage of halothane, but the actual dose is based on the physical condition of the patient.

The surgical stage of anesthesia is usually reached in 4-6 minutes.

The minimum alveolar concentration (MAC) for adults when mixed with oxygen is 0.77 vol.%, when mixed with nitrous oxide - 0.3 vol.%. MAC of halothane mixed with oxygen for children up to 6 months. - 1.08 vol.%; up to 10 years - 0.92 vol.%; for persons over 70 years old - 0.64 o6%.

At the end of the operation, the oxygen flow is increased for faster elimination of halothane and elimination of possible hypercapnia.

To avoid side effects associated with arousal vagus nerve(bradycardia, arrhythmia), the patient is administered before anesthesia or metacin. For premedication, it is preferable to use not morphine, but promedol, which excites the centers of the vagus nerve less. If it is necessary to enhance muscle relaxation, it is preferable to prescribe relaxants of a depolarizing type of action (ditilin); when using drugs of a non-depolarizing (competitive) type, the dose of the latter is reduced against the usual one. The concentration of halothane when using muscle relaxants (with controlled breathing) should not exceed 1 - 1.5 vol.%.

Side effects:From the side of the central nervous system: possible after waking up headache, tremor; increased intracranial pressure.

From the side of the cardiovascular system: arterial hypotension, bradycardia, disorders heart rate.

From the digestive system: abnormal liver function up to the development of jaundice, hepatitis, liver necrosis, especially with repeated injections; after waking up, nausea, postoperative vomiting is possible Others: respiratory depression, increased intracranial pressure, eosinophilia, the development of malignant hyperthermia is possible. Malignant hyperthermia is a very severe, often fatal, complication of anesthesia, especially in children and adolescents. Clinically, this complication is manifested by severe tachycardia, a drop in blood pressure, impaired gas exchange, and a sharp increase in the child's body temperature up to 40-42 ° C. Malignant hyperthermia can quickly lead to cerebral edema and death.

The syndrome of malignant hyperthermia is usually observed in individuals with a hereditary predisposition to malignant hyperthermia. Body temperature quickly rises to 42 ° C (!) and above, generalized rhabdomyolysis occurs, and pronounced acidosis develops.

The possibility of developing malignant hyperthermia should be remembered in case of insufficient muscle relaxation at the beginning of anesthesia, as well as in the event of fasciculations in response to the administration of dithylin. In some patients, the first sign of muscle damage is trismus, which develops during intubation. Although the increase in temperature is the result of the contractile activity of the muscles, it can increase very quickly.

Overdose: Symptoms: severe bradycardia, arrhythmias, hypotension, hyperthermic crisis, depressed respiration.

Treatment: IVL with pure oxygen, symptomatic therapy.

Interaction: Sympathomimetics increase the risk of developing arrhythmias. It enhances the effect of non-depolarizing muscle relaxants, antihypertensive agents, bradycardia under the influence of digitalis preparations and cholinesterase inhibitors (neostigmine), weakens the effect of uterotonic agents. and derivatives of phenothiazines increase the depressant effect on the central nervous system.

Increases the risk of liver damage on the background of phenytoin. Aminoglycosides and polymyxins deepen neuromuscular blockade (may cause sleep apnea). increases the half-life, nitrous oxide, and phenothiazines - the power of general anesthesia. The likelihood of developing malignant hyperthermia increases suxamethonium, arrhythmias - xatin.

Enhances and prolongs the action and toxicity of tubocurarine chloride.

Ganglioblockers are prescribed in smaller doses, since their action is potentiated by halothane.

With the combination of oxytocin with halothane, arterial hypotension, sinus bradycardia, and abnormal atrioventricular rhythm in the mother during childbirth are possible.

In combination with MAO inhibitors, the risk of high blood pressure increases.

In addition, MAO inhibitors exacerbate the toxic effect of halothane. The use of the beta-blocker timolol in the form of eye drops before surgery during halothane anesthesia can cause hypotension and bradycardia.

Special instructions:Fluorotan has hepatotoxicity, as it is converted in the liver to free radicals initiators of lipid peroxidation, and also forms metabolites (fluoroethanol), covalently binding to biomacromolecules. The frequency of hepatitis is 1 case per 10,000 anesthesia in adult patients. In children, liver damage develops much less frequently.

Causes muscle relaxation, so it should be used with caution in patients with myasthenia gravis and / or when used simultaneously with aminoglycoside antibiotics. During anesthesia, there may be an increase in blood flow in the vessels of the brain and / or an increase in intracranial pressure. These effects are usually more pronounced in the presence of intracranial neoplasms. To counteract these effects, moderate hyperventilation is used in neurosurgery.

There is a risk of developing unsystematic tachycardia in children.

Monitoring the state of the patient in anesthesia is carried out by monitoring the pulse, blood pressure (measured manually or automatically, by direct and indirect methods), continuous ECG recording, oxygen content in the blood (observing the color of the skin and mucous membranes, using a pulse oximeter or analysis blood), temperature of the "core" and the surface of the body, the reaction of the pupils, the rate of diuresis, blood tests for gases, electrolyte composition and acid-base state.

Do not store in evaporators; before new use, the evaporator must be cleaned of halothane residues and its decomposition products. Thymol (used for stabilization) does not evaporate, remains in the evaporator, coloring the solution in a yellowish color, it is highly soluble, eliminated with ether. It is necessary to cancel levodopa 6-8 hours before the start of general anesthesia.

Patients with chronic alcoholism require large doses for anesthesia.

Influence on the ability to drive transport. cf. and fur.:

During the day after anesthesia, you should refrain from driving vehicles, machines and mechanisms.

Release form / dosage:Liquid for inhalation. Package: 50 ml in orange glass dropper bottles or brown glass bottles for medical preparations, packed with instructions for use in cardboard packs for consumer packaging in accordance with GOST 7933-89. Storage conditions:Store in a dry, dark place at temperatures up to 15 ° C

Fluorotan is used only in medical institutions.

Best before date: Shelf life 3 years. Do not use after the expiration date. Close Instructions

Recipe (International)

Rp.: Phtorotani 250 ml.
D.t.d. N.1.
S. For inhalation anesthesia.

pharmachologic effect

Causes a rapid introduction to anesthesia with no or minimal manifestation of the excitation stage. It has an analgesic and muscle relaxant effect (does not create sufficient relaxation of the muscles, and therefore additional use of muscle relaxants is required). Blocks sympathetic ganglia nervous system, dilates the arteries of the skin and muscles, lowers blood pressure. Increases the tone of n.vagus, causes bradycardia. Due to the direct negative inotropic action, it reduces myocardial contractility and stroke volume. By increasing the sensitivity of cardiomyocytes to catecholamines, it increases the likelihood of developing arrhythmias. Does not irritate the respiratory tract, does not cause an increase in the secretion of saliva and bronchial glands, has a moderate bronchodilating effect, inhibits cough and gag reflexes; in proportion to the depth of general anesthesia weakens the contractility of the uterus; does not cause acidosis. At a concentration of 0.5 to 3-4 vol.%, the surgical stage of anesthesia is reached in 4-6 minutes, after the end of general anesthesia, awakening occurs in 5-15 minutes.

Mode of application

For adults: Suitable for any type of inhalation anesthesia. The correct dosage is achieved with a calibration evaporator located outside the closed circulation system (to avoid overdosing).
If it is necessary to enhance muscle relaxation, it is preferable to prescribe muscle relaxants of a depolarizing type of action (ditilin); when using drugs of a non-depolarizing (competitive) type, the dose of the latter is reduced against the usual one. The concentration of halothane when using muscle relaxants (with controlled ventilation of the lungs) should not exceed 1-1.5 vol. %.

Introduction to anesthesia begins with the supply of halothane at a concentration of 0.5 vol. % (with oxygen), then gradually increase the concentration of halothane vapor in the mixture to 2-4 vol. %. The usual maintenance concentration is 0.5-2 vol. %. The concentration in the blood is 7-12 vol. % corresponds to the surgical stage of general anesthesia. The minimum alveolar concentration (MAC) for adults when mixed with oxygen is 0.77 vol. %, when mixed with nitrous oxide - 0.3 vol. %. MAC of halothane mixed with oxygen for children up to 6 months. - 1.08 vol. %; up to 10 years -0.92 vol. %; for persons over 70 years old -0.64 vol. %. For premedication, it is preferable to use not morphine, but promedol, which excites the centers of the vagus nerve less.

Arterial pressure usually decreases, which is partly due to the inhibitory effect of the drug on the sympathetic ganglia and with the expansion of peripheral vessels. The tone of the vagus nerve increases, and therefore bradycardia is possible. To some extent, halothane has a depriming effect on the myocardium. In addition, halothane increases the sensitivity of the myocardium to catecholamines; administration of epinephrine and norepinephrine during anesthesia can cause ventricular fibrillation

Indications

Inhalation general anesthesia for large and small surgical interventions, diagnostic procedures in various categories of patients (including those with chronic obstructive pulmonary diseases, bronchial asthma and diabetes)

Fluorothane anesthesia is used in various surgical interventions, including on the organs of the abdominal and thoracic cavities, in children and the elderly with bronchial asthma. The use of halothane is especially indicated in cases where it is necessary to avoid excitation and stress of the patient (in neurosurgery, ophthalmology, etc.).

Contraindications

Hypersensitivity to the drug;
- malignant hyperthermia (in history against the background of halothane);
- jaundice, liver disease;
- cranial hypertension;
- the need for local application of epinephrine in the surgical field (risk of arrhythmia);
- pheyochromocytoma;
- hyperthyroidism;
- hypercatecholaminemia;
- liver failure;
- arterial hypotension;
- arrhythmia;
- myasthenia gravis;
- increased intracranial pressure;
- use of halothane for general anesthesia less than 3 months ago;
- pregnancy (1 trimester), childbirth and early postpartum period.
Anesthesia with halothane should not be used in case of pheochromocytoma and in other cases when the content of adrenaline in the blood is increased, with severe hyperthyroidism.

Side effects

Headache, tremor, intracranial hypertension, nausea;
- arterial hypotension, bradycardia, cardiac arrhythmias, arrhythmias;
- in some cases, liver dysfunction with the appearance of jaundice, hepatitis, liver necrosis is possible, especially with repeated injections;
- respiratory depression;
- in some cases, the development of malignant hyperthermia is possible.

After awakening, postanesthetic dimeritis is possible.
During gynecological operations, it should be borne in mind that halothane can cause a decrease in the tone of the uterine muscles and increased bleeding, so its use in obstetric and gynecological practice should be limited only to those cases where uterine relaxation is indicated. Under the influence of halothane, the sensitivity of the uterus to drugs that cause its contraction (ergot alkaloids, oxytocin) decreases.

Release form

Liquid for inhalation 50, 250 ml: fl. or bottle droppers 1, 20 or 64 pcs.
Liquid for inhalation is a clear, colorless, heavy, mobile, volatile liquid with an odor reminiscent of chloroform.
100 g - halothane 99.99 g
Excipients: thymol - 0.01 g.
50 ml - dark glass bottles (1) - packs of cardboard.
50 ml - dark glass dropper bottles (1) - packs of cardboard.
50 ml - dark glass bottles (1) - cardboard packs (20) - cardboard boxes.
50 ml - dark glass bottles (1) - cardboard packs (64) - cardboard boxes.
50 ml - dark glass dropper bottles (1) - cardboard packs (20) - cardboard boxes.
50 ml - dark glass dropper bottles (1) - cardboard packs (64) - cardboard boxes.

ATTENTION!

The information on the page you are viewing was created for informational purposes only and does not promote self-treatment in any way. The resource is designed to familiarize healthcare professionals with additional information about certain medicines, thereby increasing their level of professionalism. The use of the drug "" without fail provides for a consultation with a specialist, as well as his recommendations on the method of application and dosage of the medicine you have chosen.

Fluorothane (Phtorothanum)

Composition

1,1,1-Trifluoro-2-chloro-2-bromoethanol.
Colorless, transparent, mobile, easily volatile liquid with an odor reminiscent of chloroform, sweet and burning taste. Density 1.865 - 1.870. Boiling point (distillation) + 49 - 51 C °. Slightly soluble in water (0.345%), miscible with anhydrous alcohol,
ether, chloroform, trichlorethylene, oils. Partition coefficient oil/water 330. Vapor pressure at +20°C
equal to 241.5 mm Hg. Art. Fluorotan does not burn and does not ignite. Under the action of light, halothane slowly decomposes.

pharmachologic effect

A powerful narcotic for inhalation anesthesia.
Pharmacokinetically, halothane is easily absorbed from the respiratory tract and rapidly excreted by the lungs unchanged; only a small part of halothane is metabolized in the body. The drug has a rapid narcotic effect, which stops shortly after the end of inhalation.
Vapors of halothane do not cause irritation of mucous membranes. There are no significant changes in gas exchange during anesthesia with halothane; arterial pressure usually decreases, which is partly due to the inhibitory effect of the drug on the sympathetic ganglia and the expansion of the peripheral vessels. The vagus nerve tone remains high, which creates conditions for bradycardia. To some extent, halothane has a depriming effect on the myocardium. In addition, halothane increases the sensitivity of the myocardium to catecholamines: the introduction of adrenaline and norepinephrine during anesthesia can cause ventricular fibrillation. Fluorotan does not affect kidney function.

Indications for use

Fluorotan is a powerful narcotic, which allows it to be used alone (with oxygen or air) to achieve the surgical stage of anesthesia or as a component of combined anesthesia in combination with other drugs, mainly nitrous oxide.
Under halothane anesthesia, various surgical interventions can be performed, including on the organs of the abdominal and thoracic cavities,
in children and the elderly. Non-flammability makes it possible to use it when using electrical and X-ray equipment during surgery.
Fluorotan is convenient for use in operations on the organs of the chest cavity, as it does not cause irritation of the mucous membranes of the respiratory tract, inhibits secretion, relaxes the respiratory muscles, which facilitates artificial ventilation of the lungs. Fluorothane anesthesia can be used in patients with bronchial asthma. The use of halothane is especially indicated in cases where it is necessary to avoid excitation and stress of the patient (neurosurgery, ophthalmic surgery, etc.).

Mode of application

For introduction into anesthesia, they begin with the supply of halothane at a concentration of 0.5 vol. % (with oxygen), then within 1.5 - 3 min increase it to 3-4 vol. %. To maintain the surgical stage of anesthesia, a concentration of 0.5 - 2 vol. %.
When using halothane, consciousness usually turns off 1-2 minutes after the start of inhalation of its vapors. After 3-5 minutes, the surgical stage of anesthesia begins. After 3-5 minutes after stopping the supply of halothane, the patients begin to wake up. Anesthetized depression completely disappears in 5-10 minutes after short-term and 30-40 minutes after prolonged anesthesia. Excitation is observed rarely and is poorly expressed.
During anesthesia with halothane, the supply of its vapors should be precisely and smoothly regulated. It is necessary to take into account the rapid change of stages of anesthesia. Therefore, halothane anesthesia is carried out using special evaporators located outside the circulation system. The concentration of oxygen in the inhaled mixture must be at least 50%. For short-term operations, halothane is sometimes also used with a conventional anesthesia mask. When applying halothane to the mask in the amount of 30-40 drops per minute, the excitation period lasts about 1 minute, and the surgical stage of anesthesia usually occurs at 3-5 minutes. As a rule, they start with the supply of halothane to the mask at a rate of 5-15 drops per minute, then the supply is quickly increased to 30-50 drops per minute; to maintain the surgical stage of anesthesia, 10-25 drops per minute are applied. It is not recommended to use halothane through a mask in children.
In order to avoid side effects associated with excitation of the vagus nerve (bradycardia, arrhythmia), atropine or metacin is administered to the patient before anesthesia. For premedication, it is preferable to use not morphine, but promedol, which excites the centers of the vagus nerve less.
If it is necessary to enhance muscle relaxation, it is preferable to prescribe relaxants of a depolarizing type of action (ditilin); when applying
drugs of a non-depolarizing (competitive) type, the dose of the latter is reduced against the usual one. The concentration of halothane when using
muscle relaxants (with controlled breathing) should not exceed 1 - 1.5 vol.%.
Ganglioblockers are prescribed in smaller doses, since their action is potentiated by halothane.

Side effects

During anesthesia with halothane, due to inhibition of sympathetic ganglia and expansion of peripheral vessels, increased bleeding is possible, which requires careful hemostasis, and, if necessary, compensation for blood loss.
Due to the rapid awakening after the cessation of anesthesia, patients may feel pain, so early use of analgesics is necessary.
Sometimes in the postoperative period there is a chill (due to vasodilation and heat loss during surgery). In these cases, patients need to be warmed with heating pads. Nausea and vomiting usually do not occur, but the possibility of their occurrence in connection with the administration of analgesics (morphine) should be considered.
It should be borne in mind that people working with halothane may develop allergic reactions.

Contraindications

Anesthesia with halothane should not be used, with pheochromocytoma (adrenal gland tumors), severe hyperthyroidism (disease thyroid gland) and in other cases when the content of adrenaline in the blood is increased, with severe hyperthyroidism. It should be used with caution in patients with cardiac arrhythmias, hypotension, organic lesions liver. During gynecological operations, it should be borne in mind that halothane can cause a decrease in the tone of the muscles of the uterus and increased bleeding. The use of halothane in obstetrics and gynecology should be limited only to those cases where uterine relaxation is indicated. Under the influence of halothane, the sensitivity of the uterus to drugs that cause its contraction (ergot alkaloids, oxytocin) decreases.
When anesthesia with halothane, adrenaline and norepinephrine should not be used to avoid arrhythmias.

Release form

In well-corked orange glass bottles of 50 ml. Attention!
Description of the drug Fluorotan"on this page is a simplified and expanded version official instructions by application. Before purchasing or using the drug, you should consult your doctor and read the annotation approved by the manufacturer.
Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide on the appointment of the drug, as well as determine the dose and methods of its use. liquid for inhalation 50 ml: fl. or bottle droppers 1, 20 or 64 pcs.
Reg. No: RK-LS-5 No. 016597 dated 09/22/2010 - Valid

Liquid for inhalation transparent, colorless, heavy, mobile, volatile liquid with an odor reminiscent of chloroform.

Excipients: thymol - 0.01 g.

50 ml - dark glass bottles (1) - packs of cardboard.
50 ml - dark glass dropper bottles (1) - packs of cardboard.
50 ml - dark glass bottles (1) - cardboard packs (20) - cardboard boxes.
50 ml - dark glass bottles (1) - cardboard packs (64) - cardboard boxes.
50 ml - dark glass dropper bottles (1) - cardboard packs (20) - cardboard boxes.
50 ml - dark glass dropper bottles (1) - cardboard packs (64) - cardboard boxes.

Description medicinal product FLUOROTANE was created in 2015 on the basis of instructions posted on the official website of the Ministry of Health of the Republic of Kazakhstan. Date of update: 06/01/2015

pharmachologic effect

Causes a rapid introduction to anesthesia with no or minimal manifestation of the excitation stage. It has an analgesic and muscle relaxant effect (does not create sufficient relaxation of the muscles, and therefore additional use of muscle relaxants is required). Blocks the ganglia of the sympathetic nervous system, dilates the arteries of the skin and muscles, lowers blood pressure. Increases the tone of n.vagus, causes bradycardia. Due to the direct negative inotropic action, it reduces myocardial contractility and stroke volume. By increasing the sensitivity of cardiomyocytes to catecholamines, it increases the likelihood of developing arrhythmias. Does not irritate the respiratory tract, does not cause an increase in the secretion of saliva and bronchial glands, has a moderate bronchodilating effect, inhibits cough and gag reflexes; in proportion to the depth of general anesthesia weakens the contractility of the uterus; does not cause acidosis. At a concentration of 0.5 to 3-4 vol.%, the surgical stage of anesthesia is reached in 4-6 minutes, after the end of general anesthesia, awakening occurs in 5-15 minutes.

Pharmacokinetics

When inhaled, it is absorbed from the lumen of the alveoli into the bloodstream, the concentration in the alveoli and blood quickly balances. It is distributed to organs with good vascularization (brain, heart, liver), muscles, adipose tissue. Quickly passes histohematic barriers, including blood-brain and placental. After the cessation of entry into the body, the decrease in its concentration in plasma is exponential. It is excreted by the lungs - 80% unchanged; kidneys - 20% in the form of inactive metabolites.

Indications for use

- inhalation general anesthesia for large and small surgical interventions, diagnostic procedures in various categories of patients (including chronic obstructive pulmonary diseases, bronchial asthma and diabetes mellitus);

— Fluorothane anesthesia is used in various surgical interventions, including on the organs of the abdominal and thoracic cavities, in children and the elderly with bronchial asthma. The use of halothane is especially indicated in cases where it is necessary to avoid excitation and stress of the patient (in neurosurgery, ophthalmology, etc.).

Dosing regimen

Suitable for any type of inhalation anesthesia. The correct dosage is achieved with a calibration evaporator located outside the closed circulation system (to avoid overdosing). If it is necessary to enhance muscle relaxation, it is preferable to prescribe muscle relaxants of a depolarizing type of action (ditilin); when using drugs of a non-depolarizing (competitive) type, the dose of the latter is reduced against the usual one. The concentration of halothane when using muscle relaxants (with controlled ventilation of the lungs) should not exceed 1-1.5 vol. %.

Introduction to anesthesia begins with the supply of halothane at a concentration of 0.5 vol. % (with oxygen), then gradually increase the concentration of halothane vapor in the mixture to 2-4 vol. %. The usual maintenance concentration is 0.5-2 vol. %. The concentration in the blood is 7-12 vol. % corresponds to the surgical stage of general anesthesia. The minimum alveolar concentration (MAC) for adults when mixed with oxygen is 0.77 vol. %, when mixed with nitrous oxide - 0.3 vol. %. MAC of halothane mixed with oxygen for children up to 6 months. - 1.08 vol. %; up to 10 years -0.92 vol. %; for persons over 70 years old -0.64 vol. %. For premedication, it is preferable to use notmorphine, but promedol, which excites the centers of the vagus nerve less.

When using halothane, consciousness usually turns off 1-2 minutes after the start of inhalation of its vapors. After 3-5 minutes, the surgical stage of anesthesia begins. After 3-5 minutes after stopping the supply of halothane, the patients begin to wake up. Anesthesia depression completely disappears in 5-10 minutes after short-term and 30-40 minutes after prolonged anesthesia. Excitation is observed rarely and is poorly expressed. Halothane vapors do not cause irritation of the mucous membranes of the respiratory tract, inhibit secretion, relax the respiratory muscles, which facilitates artificial ventilation of the lungs. There are no significant changes in gas exchange during anesthesia with halothane. Blood pressure usually decreases, which is partly due to the inhibitory effect of the drug on the sympathetic ganglia and the expansion of peripheral vessels. The tone of the vagus nerve increases, and therefore bradycardia is possible. To some extent, halothane has a depriming effect on the myocardium. In addition, halothane increases the sensitivity of the myocardium to catecholamines; the introduction of epinephrine and norepinephrine during anesthesia can cause ventricular fibrillation.

Side effects

- headache, tremor, intracranial hypertension, nausea;

- arterial hypotension, bradycardia, cardiac arrhythmias, arrhythmias;

- in some cases, liver dysfunction with the appearance of jaundice, hepatitis, liver necrosis is possible, especially with repeated injections;

- respiratory depression;

- in some cases, the development of malignant hyperthermia is possible.

After awakening, postanesthetic dimeritis is possible.

During gynecological operations, it should be borne in mind that halothane can cause a decrease in the tone of the uterine muscles and increased bleeding, so its use in obstetric and gynecological practice should be limited only to those cases where uterine relaxation is indicated. Under the influence of halothane, the sensitivity of the uterus to drugs that cause its contraction (ergot alkaloids, oxytocin) decreases.

Contraindications for use

hypersensitivity to the drug;
malignant hyperthermia (history against the background of halothane);
jaundice, liver disease;
cranial hypertension;
the need for local application of epinephrine in the surgical field (risk of arrhythmia);
pheyochromocytoma;
hyperthyroidism;
hypercatecholaminemia;
liver failure;
arterial hypotension;
arrhythmia;
myasthenia gravis;
increased intracranial pressure;
use of halothane for general anesthesia less than 3 months ago;
pregnancy (1 trimester), the period of childbirth and the early postpartum period.

Anesthesia with halothane should not be used in case of pheochromocytoma and in other cases when the content of adrenaline in the blood is increased, with severe hyperthyroidism.

Use during pregnancy and lactation

Contraindicated during pregnancy (1 trimester), during childbirth and in the early postpartum period.

The use of halothane in obstetrics - gynecological practice should be limited only to those cases where the relaxation of the uterus is indicated. Under the influence of halothane, the sensitivity of the uterus to drugs that cause it to contract (ergot alkaloids, oxytocin) decreases.

Fluorotan is not usually contraindicated in breastfeeding.

special instructions

Fluorotan is not usually contraindicated in breastfeeding.

In the elderly and senile age, the use of halothane should be limited.

Halothane should not be used during pregnancy (I trimester),

When anesthesia with halothane, adrenaline and norepinephrine should not be used to avoid arrhythmias. It should be borne in mind that people working with halothane may develop allergic reactions.

Under halothane anesthesia, various surgical interventions can be performed, including on the organs of the abdominal and thoracic cavities, in children and the elderly. It is not recommended to use halothane through a mask in children.

The use of halothane is especially indicated in cases where it is necessary to avoidarousaland tension of the patient (neurosurgery, ophthalmic surgery, etc.).

Non-flammability makes it possible to use when using electrical and X-ray equipment during surgery.

Overdose

Symptoms:severe bradycardia, arrhythmias, hypotension, hyperthermic crisis, depressed respiration.

Treatment:IVL with pure oxygen, symptomatic therapy.

drug interaction

Sympathomimetics increase the risk of developing arrhythmias. Enhances the action of non-depolarizing muscle relaxans, antihypertensive drugs, bradycardia under the influence of digitalis preparations and cholinesterase inhibitors (neostigmine), weakens the effect of uterotonic agents. Morphine and phenothiazines increase the depressant effect on the central nervous system.

Increases the risk of liver damage on the background of phenytoin. Aminoglycosides, lincomycin and polymyxins deepen neuromuscular blockade (may cause sleep apnea). Ketamine increases the half-life, methyldopa, nitrous oxide, morphine and phenothiazines - the power of general anesthesia. The likelihood of developing malignant hyperthermia increases suxamethonium, arrhythmias - xatin.

General anesthesia: induction and maintenance of anesthesia during surgical operations (including during chronic diseases respiratory tract), including caesarean section.

Dosage and administration

Maintenance of the surgical stage of anesthesia - at a concentration of 0.5-2%; for introduction into anesthesia, the concentration is gradually increased to 4%. The required concentration in the blood - 25%; the minimum anesthetic concentration is 15% for adults; 1.08%, 0.92%, 0.64%, respectively, for infants, children under 10 years of age and patients over 70 years of age.

Contraindications

Hypersensitivity, acute liver damage, jaundice, malignant hyperthermia, pheochromocytoma, arrhythmia, myasthenia gravis, traumatic brain injury, increased intracranial pressure; the need for local application of adrenaline during the operation; gynecological operations, in which the relaxation of the uterus is contraindicated; I trimester of pregnancy; 3-month period after halothane anesthesia.

Side effects

Arrhythmia, bradycardia, arterial hypotension, respiratory depression, headache, tremor upon awakening, postanesthetic chills, nausea, jaundice, hepatitis (with repeated administration), malignant hyperthermic crisis, postanesthetic delirium.

Overdose

Symptoms: severe bradycardia, arrhythmia, hypotension, hyperthermic crisis, respiratory depression. Treatment: artificial ventilation of the lungs with pure oxygen.

Pharmacological group

Means for inhalation anesthesia

pharmachologic effect

General anesthetic, analgesic, muscle relaxant. Depresses the central nervous system and causes anesthesia. Blocks the sympathetic ganglia, increases the tone of the vagus nerve, reduces myocardial contractility, sensitizes the myocardium to catecholamines. Lowers systemic blood pressure; expands the bronchi; inhibits salivation; inhibits cough and gag reflexes. It is easily absorbed and quickly passes histohematic barriers, including the BBB and placental. A small part is metabolized in the liver. It is excreted mainly by the lungs unchanged, a small amount - by the kidneys (including biotransformation products - bromides, chlorides and trifluoroacetic acid).

Composition

Active ingredient: Halothane.

Interaction

Enhances the effect of antidepolarizing muscle relaxants, antihypertensive drugs, digitalis preparations and m-cholinomimetics. Weakens the tachycardia caused by trimetafan. Increases the risk of liver damage on the background of phenytoin. Aminoglycosides, lincomycin and polymyxins deepen neuromuscular blockade (may cause sleep apnea). Ketamine increases the half-life, methyldopa, nitrous oxide, morphine and phenothiazines - the power of anesthesia. The likelihood of developing malignant hyperthermia increases suxamethonium, arrhythmias - xanthine.

special instructions

It should be borne in mind that the introduction of adrenaline and other sympathomimetics increases the risk of developing arrhythmias. It is necessary to cancel levodopa 6-8 hours before the onset of anesthesia. Patients with chronic alcoholism require large doses for anesthesia.

Storage conditions

List B. In a dry, cool, dark place.