Pharmacology · Inhaled anaesthetics
Desflurane !
The inhaled anaesthetic least soluble in blood: the fastest emergence. It strongly irritates the airway and is not used for induction in children.
Updated 2026-11-01
Mechanism of action
Desflurane, a volatile fluorinated ether, depresses neuronal activity by enhancing inhibitory receptors and modulating potassium channels, like the other halogenated agents. Its blood solubility is the lowest of the group, so brain concentration changes very quickly and emergence is fast. It boils close to room temperature and needs a special heated vaporiser. It is very irritating: cough, apnoea and laryngospasm if inhaled while awake.
- Inhaled through a special heated vaporiser
- Very poorly soluble in blood: very fast equilibrium
- Depresses neuronal activity: anaesthesia
- Exhaled quickly: fast emergence
Pharmacokinetics
- Absorption
- Through the lungs; the lowest blood solubility of the group.
- Metabolism
- Minimal hepatic metabolism.
- Elimination
- Almost all is exhaled unchanged.
Indications
- Induction in adults and maintenance of general anaesthesia for outpatient and inpatient surgery; in children, maintenance only with the patient intubated
Adverse effects
Common
- Cough, apnoea, breath-holding, laryngospasm and secretions
- Tachycardia and hypertension when the concentration rises quickly
- Nausea and vomiting
Contraindications
- Known or suspected genetic susceptibility to malignant hyperthermia
- Hypersensitivity to halogenated agents or previous hepatitis from one
- Induction of anaesthesia in children (serious airway events)
Key interactions
- Non-depolarising blockers
- Enhances the block.
- Suxamethonium
- Higher risk of malignant hyperthermia.
- Nitrous oxide and opioids
- Lower the MAC.
What is monitored
- End-tidal agent concentration
- Heart rate and blood pressure
- Airway, end-tidal CO2 and temperature
Administration and safety
- Only with the vaporiser specific for desflurane.
- Replace a desiccated CO2 absorbent: it can form carbon monoxide.
- Keep dantrolene available.
Nursing care
- Before: history of malignant hyperthermia, asthma or reactive airway.
- In recovery: watch for cough, laryngospasm, saturation and nausea.
- Fast emergence: have postoperative analgesia planned before anaesthesia ends.
Pregnancy and breastfeeding
Like the other halogenated agents, it relaxes uterine smooth muscle.
Test yourself
Think of the answer, then tap the question to see it.
Why does desflurane allow the fastest emergence?
Because it is the least soluble in blood of the halogenated anaesthetics.
Why is desflurane contraindicated for induction of anaesthesia in children?
It is very irritating to the airway: it frequently causes cough, apnoea, breath-holding, laryngospasm and secretions.
What cardiovascular effect can a sudden rise in desflurane concentration have?
Transient sympathetic activation with tachycardia and hypertension.
Related drugs
← Back to the class: Inhaled anaesthetics
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - DESFLURANE liquid (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 24 (McGraw Hill, 2023); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake
Representative model, for educational purposes only.