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Sevoflurane inside and outside the operating room

Background: Sevoflurane is often presented as a near-perfect anaesthetic. After 10 years in the operating room, new uses are emerging outside. Objective: To remind readers of the principal characteristics of sevoflurane, to affirm its usefulness for day-case anaesthesia and to consider the recent new uses. Methods: The discussion of the physical properties, pharmacokinetics, metabolism, mechanisms of action and clinical effects is based on classic, essential papers. Recent literature concerning emerging utilizations of sevoflurane was analysed. Results: Sevoflurane presents many benefits with minimum inconvenience. It allows rapid inhalation induction, maintenance and rapid recovery. It has little toxicity and its haemodynamic and respiratory depressive effects are moderate and well tolerated. It is already widely use for sedation for magnetic resonance imaging in children. Its use in paediatric or adult intensive care could improve the management of pain and sedation.