In vitro & nbsp;assessment of the direct hemolytic effect of the volatile halogenated anesthetics sevoflurane, isoflurane, and desflurane

Sevoflurane is being repurposed as a topical analgesic for painful wounds. Providing pre-charged sevoflurane syringes to irrigate wounds implies a potential risk of accidental intravenous injections. We assessed the potential of two concentrations (33% and 50% v/v) of three anesthetics, isoflurane, desflurane and sevoflurane, to produce hemolysis in vitro. Spectrophotometric absorbance was read at 576 nm. For both concentrations, the percentage of hemolysis (mean +/- SD) was higher for isoflurane (29.7 +/- 3.4% and 39.5 +/- 5.3%), mild for desflurane (8.0 +/- 0.5% and 6.5 +/- 0.9%) and negligible for sevoflurane (0.7 +/- 0.0% and 0.6 +/-& nbsp;0.1%), respectively. In conclusion, in contrast to isoflurane and desflurane, sevoflurane did not display hemolytic potential in vitro. However, the use of syringes preloaded with sevoflurane may still be problematic if it increases the possibility of inadvertent intravenous administration through increased risk of gas embolism and severe central nervous system depression.