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iOS App Map

  1. 1. Features Reasons to Believe Brand Positioning Hemodynamic Stability RapidRecovery AirwayTolerability Procedures DES+ve SEVO +ve ISO +ve SEVOrane® Message Map Titratability
  2. 2. SEVOrane is the original fast acting, cost-effective anesthetic agent offering the clinical versatility and predictability needed through speed, control and cardio- protective effects ideally suited for all general anesthetic procedures. ® Brand Positioning Back
  3. 3. “Sevoflurane: The best volatile anesthetic ever developed” Dr.LarsonUCLA /Stanford University LINK83 A passion for anesthesia and a commitment to excellence leading to 18 years of trust between Abbott and the worldwide anesthesia community The #1 worldwide inhalational anesthetic, the gold standard for all procedure types SEVOrane represents the cornerstone of today’s anesthesia around the world (Continued) Reasons toBelieve
  4. 4. Reasons toBelieve Abbott SEVOranehas been commercialized in over 85 countries around the world Back
  5. 5. HemodynamicStability  SEVOrane offers ideal cardiovascular stability and has demonstrated exemplary cardio protective effects LINK 1 SEVOrane had a stable cardiovascular profile, particularly in aged patients LINK 4  When managing elderly patients, SEVOrane provided a more stable cardiovascular homeostasis compared to isoflurane LINK 4  Hypotension was observed in 16 patients receiving isoflurane and in 5 patients receiving SEVOrane (p<0.02) LINK 4 Back
  6. 6. Airway Tolerability  SEVOrane has a pleasant, non-irritating aroma, which allows for inhalational induction in adults and children with minimum excitement or signs of upper respiratory irritation LINK 1  SEVOrane is fast acting non irritating agent, and is associated with a smooth, rapid loss of consciousness during inhalational induction LINK 1  SEVOrane is an excellent option for use in patients breathing through an LMA LINK 1 Back
  7. 7. Airway Tolerability  SEVOrane was associated with a lower incidence of coughing and signs of airway irritation than isoflurane and desflurane. LINK 2  At 2 MAC concentration, SEVOrane is significantly less irritating on the airways than isoflurane and desflurane. LINK 2  Smokers inhaling isoflurane had a 45% incidence of adverse airway events compared to 10% in those inhaling SEVOrane. LINK 3 Back
  8. 8. Rapid Recovery Back  SEVOrane facilitates fast track eligibility LINK 104  SEVOrane allowed for a significantly faster emergence from anaesthesia than isoflurane LINK 4
  9. 9. Titratability to Response  Blood:Gas: Determines the speed at which an agent will saturate the blood stream. The lower the number, the faster the agent will be washed-in and eliminated. Brain:Blood: Determines the speed at which the agent will enter and leave the cerebral tissues, important for neuro-anesthesia post surgical assessment. The lower the number the faster the agent. Compare with Isoflurane and Desflurane. SEVOrane is closest to N20 Agent Blood:Gas Partition Coefficient Brain:Blood Partition Coefficient Halothane 2.4 2.9 Enflurane 1.9 1.4 Isoflurane 1.42 2.6 Desflurane 0.42 1.3 Nitrous Oxide 0.47 1.1 SEVOrane 0.63 - 0.69 1.15 Key Coefficients of Volatile Agents * Continue
  10. 10. Versatility & Predictability The features of SEVOrane: Hemodynamic stability Airway tolerability Rapid recovery Titratability All translate into the ideal inhalational anesthetic for all procedures and patient types: pediatrics, adults and elderly That’s the SEVOrane Versatility and Predictability ! Back
  11. 11. DES +ve CardiacProcedure Ambulatory Procedures Obese ProceduresNeurological procedures Back Toxicity COMPA Pollution
  12. 12. Cardiovascular Procedures v Desflurane Anesthesiologist’s Goal: Stability & Speed Hemodynamic Stability • Sevoflurane maintains mean arterial pressure better than desflurane. LINK 98 • Sevoflurane shows a lower incidence of postoperative atrial fibrillation than propofol, desflurane and midazolam. LINK 13 • Desflurane appears to cause a greater systemic and intrapulmonary pro-inflammatory response than sevoflurane. LINK 60 Back
  13. 13. Neurologic Procedures vDesflurane Anesthesiologist’s Goal: Speed & Stability Stability • Patients receiving desflurane demonstrated greater cerebral artery blood flow velocities, heart rates and blood pressures than those receiving sevoflurane. LINK 74 • Desflurane causes more cerebral vasodilatation at hypocapnia therefore less suitable for neuro Anesthesia (study done with Pigs) LINK 109 Back
  14. 14. Ambulatory Procedures v Desflurane Anesthesiologist’s Goal: Rapid Recovery & Airway Tolerability Rapid Recovery & Smooth Emergence • Wake up times were faster with Desflurane but the hospital discharge times were faster with sevoflurane. LINK 108 Airway Tolerability • Desflurane enhances reactivity during the use of the LMA. LINK 22 • Sevoflurane is a better bronchodilator than desflurane. LINK 23 • Sevoflurane is non-pungent and produces minimal airway irritations. LINK 27 • Initiation of desflurane anesthesia resulted in significant changes which resulted in hypertension, tachycardia, facial flushing, tearing and moderate upper airway obstruction. This study observes response to desflurane, it uses no sevoflurane. LINK 110 Back
  15. 15. 15 Obesity Articles Vs. Desflurane • No clinically relevant difference was found in recovery in the PACU between morbidly obese patients anesthetized with desflurane or sevoflurane. LINK 35 • No difference in emergence and recovery profile in morbidly obese patients receiving desflurane or sevoflurane. LINK 36 • Commentary: Obesity, Surgery, and Inhalational Anesthetics: Is there a Drug of Choice? LINK 81 Back
  16. 16. Toxicity Vs. Desflurane • Desflurane produces a systemic and local oxidative stress. LINK 59 • Desflurane may be capable of producing genetic damage. LINK 56 Sevoflurane • Short- term administration of sevoflurane did not induce sister Chromatic exchanges. No indication for a possible genotoxic effect has been observed. LINK 61 Back
  17. 17. Compound A Clinical Studies Low flow Sevoflurane/Low flow Isoflurane: • No statistically significant differences in measured parameters of renal function after low flow sevoflurane anesthesia compared with isoflurane. LINK 105 Low flow Sevoflurane: • No evidence for nefrotoxicity was observed with sevoflurane. LINK 106 Low flow Sevoflurane: • Prolonged low flow sevoflurane anesthesia had the same effect as high flow sevoflurane and low flow isoflurane anesthesia. LINK 107 Back
  18. 18. ORPollution - Articles Desflurane: • Even if the trace concentrations of anesthetic agents were low in the present investigation the NIOSH limit for desflurane could not be ensured. LINK 68 Desflurane & Isoflurane: • Routine use of scavenging devices during cardiopulmonary bypass is recommended. LINK 69 Swedish OR Pollution guidelines: • The guidelines are for your information. LINK 111 Back
  19. 19. Sevoflurane vs.Desflurane Back • Has a pleasant odour that does not irritate the airways • SEVOrane does not increase heart rate at < 2MAC • SEVOrane causes less air way irritability • SEVOrane is indicated for mask induction • SEVOrane is linked to a low incidence of PONV • SEVOrane is an ideal bronchodilator • Can be safely used in neurosurgery and coronary artery surgery • Can be safely used in patients at risk for myocardial ischemia • Can be used with standard vaporizer technology, desflurane requires and expensive heated vaporizer
  20. 20. ISO +ve CardiacProcedure Ambulatory ProceduresNeurological procedures Back Pollution
  21. 21. Cardiovascular Procedures v.Isoflurane Anesthesiologist’s Goal: Stability & Speed Hemodynamic Stability • Sudden increases in Isoflurane concentrations led to larger hemodynamic changes and sympathetic nerve activity than with sevoflurane. LINK 15 • Sevoflurane bolus is more effective during maintenance than remifentanil bolus for control of hemodynamic responses. LINK 17 • Preconditioning with sevoflurane decreases PECAM-1 expression and improves 1 year cardiovascular outcome in CABG surgery. LINK 19 Back
  22. 22. Neurologic Procedures vIsoflurane Anesthesiologist’s Goal: Stability & Speed Stability • Autoregulation is better preserved with sevoflurane compared to isoflurane. LINK 78 • Autoregulation was better preserved during sevoflurane than isoflurane anesthesia at 1.5 MAC concentration. LINK 79 • Sevoflurane has less intrinsic dose-dependent cerebral vasodilatory effect than isoflurane. LINK 49 • Sevoflurane demonstrates less total cerebral vasodilatory effects than isoflurane at the same depth of anesthesia. LINK 53 • Sevo shows sustained inhibition of neuronal damage. LINK 66 • Sevoflurane decreased middle cerebral artery flow velocity. LINK 73 • Editorial warning of the potential limitations of isoflurane neuroprotection. LINK 80 Rapid Recovery • Sevoflurane provides faster recovery and postoperative Neurologic assessment than Isoflurane. LINK 48 Back
  23. 23. Ambulatory Procedures v Isoflurane Anesthesiologist’s Goal: Rapid Recovery & Airway Tolerability Rapid Recovery & Smooth Emergence • Sevoflurane anesthesia recovery time is faster. LINK 39 • Sevoflurane allows for faster discharge than Isoflurane. LINK 21 • Sevoflurane allows for smoother clinical course with more rapid recovery. LINK 42 • Sevoflurane provides significantly faster emergence than Isoflurane. LINK 85 • Significantly faster emergence, orientation, response to commands compared with Isoflurane. LINK 85 Airway Tolerability • Smokers inhaling isoflurane had a 45% incidence of adverse airway event vs. 10% in the sevoflurane group. LINK 21 Back
  24. 24. ORPollution - Articles Desflurane & Isoflurane: • Routine use of scavenging devices during cardiopulmonary bypass is recommended. LINK 69 Swedish OR Pollution guidelines: • The guidelines are for your information. LINK 111 - Please consult your local regulatory department before using these clinical reprints - Continue
  25. 25. Sevoflurane vs.Isoflurane Back • Has a pleasant odour that does not irritate the airways • Is effective for induction, without the need for intravenous induction agents • Produces a rapid and smooth loss of consciousness • Maintains heart rate more effectively with less tachycardia • Appears to have less of a depressant effect on blood pressure • Provides shorter times to emergence, command response, and orientation • Two times less soluble • Rapid induction, emergence and recovery • Rapid adjustment of anesthetic depth
  26. 26. SEVO+ve Back ETC1.5% SEVO Bolus
  27. 27. • Spinal cord governs movement in response to painful stimulus under general anesthesia. LINK 111 • The reduction in MACawake by nitrous oxide is non linear and smaller than would be expected. LINK 112 • With end-tidal sevoflurane concentration increasing from 0.2% to 1.4%, BIS values decreased almost linearly from 95.3 (median) to 45.5 LINK 113 • The most frequent cause of awareness is selection of an inadequate dose of anaesthetic agent. Assurance of >0.8 MAC end-tidal makes awareness unlikely. LINK 114 • TCI devices for remifentanil and propofol result in large variation in measured serum concentrations. LINK 47 SEVOrane® Message Map 27Company Confidential © 2007 Abbott ETC 1.5% Back
  28. 28. • An inhalation bolus of sevoflurane seems to be more effective than an IV remifentanil bolus during maintenance, with more effective control of hemodynamic responses to surgical stress. LINK 115 SEVOrane® Message Map 28Company Confidential © 2007 Abbott SEVOrane Bolus Back
  29. 29. ABBOTT SEVOrane Back Quik Fil System Ready-to-use delivery system that does not require the mounting of a separate adaptor by OR staff. Designed to minimize the release of anesthetic into the room air and the risk of leakage and spillage Water content > 300ppm Protects against Lewis acid degradation and provides a stable formulation Polyethylene Naphthalate (PEN) bottle Shatter resistant, lightweight, transparent, easily recyclable, cost effective disposal, no risk of Lewis Acid formation from the bottle New Tamper Evident Shrink Band 1 3 2 4