Comparative Pharmacology
Head-to-head clinical analysis: DESFLURANE versus KETAMINE HCL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DESFLURANE versus KETAMINE HCL.
DESFLURANE vs KETAMINE HCL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Desflurane is a volatile general anesthetic that potentiates inhibitory GABA and glycine neurotransmission and inhibits excitatory NMDA glutamate receptors, leading to neuronal hyperpolarization and reduced neuronal excitability.
Noncompetitive NMDA receptor antagonist; blocks glutamate binding, and modulates opioid receptors, monoaminergic receptors, and voltage-gated calcium channels.
Induction: 3-12% inhaled, titrated to effect; maintenance: 2-6% inhaled, adjusted to maintain adequate anesthetic depth with up to 1 MAC (6.0% at 37°C, 1 atm).
Induction: 1-2 mg/kg IV; Maintenance: 0.5-1 mg/kg IV or 10-30 mcg/kg/min IV infusion; Subanesthetic: 0.1-0.5 mg/kg IV; Analgesic: IM 2-4 mg/kg; Intranasal 1-3 mg/kg. Frequency: single doses or continuous infusion per clinical need.
None Documented
None Documented
Clinical Note
moderateDesflurane + Torasemide
"The risk or severity of adverse effects can be increased when Desflurane is combined with Torasemide."
Clinical Note
moderateDesflurane + Etacrynic acid
"The risk or severity of adverse effects can be increased when Desflurane is combined with Etacrynic acid."
Clinical Note
moderateDesflurane + Furosemide
"The risk or severity of adverse effects can be increased when Desflurane is combined with Furosemide."
Clinical Note
moderateDesflurane + Bumetanide
Terminal elimination half-life is 3.5–4.5 minutes (context-sensitive half-life after prolonged anesthesia can be longer due to distribution, but true elimination is rapid due to low blood/gas partition coefficient).
Terminal elimination half-life: 2–4 hours (alpha: 10–15 min, beta: 2.5–4 hr); prolonged in hepatic impairment and with repeated dosing (up to 12–24 hr for active metabolite norketamine).
Primarily eliminated via exhalation; minimal hepatic metabolism (<0.02%). Renal excretion of metabolites negligible. >99% excreted unchanged by lungs.
Renal: 90% as metabolites (norketamine, dehydronorketamine, hydroxylated derivatives) and 4% unchanged; biliary/fecal: 3%; minor pulmonary exhalation.
Category C
Category C
General Anesthetic
General Anesthetic
"The risk or severity of adverse effects can be increased when Desflurane is combined with Bumetanide."