As with all potent inhaled anaesthetics, Sevoflurane may cause dose-dependent cardiorespiratory depression. Most adverse events are mild to moderate in severity and transient.
Nausea and vomiting are commonly observed in the post-operative period, at a similar incidence to those found with other inhalation anaesthetics. These effects are common sequelae or 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.
The type, severity and frequency of adverse events in Sevoflurane patients were comparable to adverse events in patients treated with other inhalation anaesthetics.
The most frequent adverse events associated with Sevoflurane overall were nausea and vomiting. Agitation occurred frequently in children. Other frequent adverse events associated with Sevoflurane administration overall were: increased cough and hypotension.
In addition to nausea and vomiting, other frequent adverse events by age listings were: In adults, hypotension; in elderly, hypotension and bradycardia; In children, agitation and increased cough.
Less frequent adverse events associated with Sevoflurane administration were: agitation, somnolence, chills, bradycardia, dizziness, increased salivation, respiratory disorder, hypertension, tachycardia, laryngismus, fever, headache, hypothermia, increased SGOT.
Occasional adverse events occurring during clinical trials included: arrhythmias, increased LDH, increased SGPT, hypoxia, apnoea, leukocytosis, ventricular extrasystoles, supraventricular extrasystoles, asthma, confusion, increased creatinine, urinary retention, glycosuria, atrial fibrillation, complete AV block, bigeminy, leucopenia. Malignant hyperthermia and acute kidney failure have been reported very rarely. Rare reports of post-operative hepatitis exist, but with an uncertain relationship to Sevoflurane. Convulsions may occur extremely rarely following Sevoflurane administration, particularly in children.
There have been very rare reports of pulmonary oedema.
Allergic reaction, such as rash, urticaria, pruritus, bronchospasm, anaphylactic or anaphylactoid reactions have been reported.
As with other anaesthetic agents, cases of twitching and jerking movements with spontaneous resolution have been reported in children receiving Sevoflurane for induction of anaesthesia with an uncertain relationship to Sevoflurane.
Laboratory Findings: Transient elevations in glucose and white blood cell count may occur as with use of other anaesthetic agents. Occasional cases of transient changes in hepatic function tests were reported with Sevoflurane.
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