Sevoflurane has an excellent safety record, but is under review for potential neurotoxicity, especially relevant to administration in infants and children, and rare reports similar to halothanehepatotoxicity. Sevoflurane is the preferred agent for mask induction due to its lesser irritation to mucous membranes.
Sevoflurane was discovered by Ross Terrell and independently by Bernard M Regan. A detailed report of its development and properties appeared in 1975 in a paper authored by Richard Wallin, Bernard Regan, Martha Napoli and Ivan Stern. It was introduced into clinical practice initially in Japan in 1990 by Maruishi Pharmaceutical Co., Ltd. Osaka, Japan. The rights for sevoflurane worldwide were held by AbbVie. It is now available as a generic drug.
Sevoflurane is an inhaled anaesthetic that is often used to put children asleep for surgery. During the process of waking up from the medication, it has been known to cause agitation and delirium. It is not clear if this can be prevented.
Studies examining a current significant health concern, anesthetic-induced neurotoxicity (including with sevoflurane, and especially with children and infants) are "fraught with confounders, and many are underpowered statistically", and so are argued to need "further data... to either support or refute the potential connection".
Concern regarding the safety of anaesthesia is especially acute with regard to children and infants, where preclinical evidence from relevant animal models suggest that common clinically important agents, including sevoflurane, may be neurotoxic to the developing brain, and so cause neurobehavioural abnormalities in the long term; two large-scale clinical studies (PANDA and GAS) were ongoing as of 2010, in hope of supplying "significant [further] information" on neurodevelopmental effects of general anaesthesia in infants and young children, including where sevoflurane is used.
^Sakai EM; Connolly LA; Klauck JA (December 2005). "Inhalation anesthesiology and volatile liquid anesthetics: focus on isoflurane, desflurane, and sevoflurane". Pharmacotherapy. 25 (12): 1773–88. doi:10.1592/phco.2005.25.12.1773. PMID16305297.
^ abcLivertox: Clinical and Research Information on Drug-Induced Liver Injury (2014) "Drug Record: Sevoflurane", U.S. National Library of Medicine, 2 July 2014 update, see , accessed 15 August 2014.
Wallin, Richard F., Regan, Bernard M., Napoli, Martha D., Stern, Ivan j. (Nov–Dec 1975). "Sevoflurane: A New Inhalational Anesthetic Agent". Anesthesia and Analgesia. 54 (6): 758–766. doi:10.1213/00000539-197511000-00021. PMID1239214.CS1 maint: multiple names: authors list (link)