Which inhaled anesthetic is commonly irritant to the airway and is associated with airway irritation during induction, particularly in smokers?

Which inhaled anesthetic is commonly irritant to the airway and is associated with airway irritation during induction, particularly in smokers?

• A. Isoflurane
• B. Sevoflurane
• C. Halothane
• D. Desflurane

Answer: (D)

Airway irritation from inhaled anesthetics depends on how pungent and irritant they are to the airway mucosa. Desflurane stands out because its odor is very pungent and it readily irritates the airway, provoking coughing, breath-holding, or even laryngospasm during induction. This effect is amplified in smokers, whose airways are already hyperreactive, making irritation more likely during induction with desflurane. In contrast, sevoflurane is relatively non-irritating and is commonly used for smooth inhalational induction, while isoflurane and halothane are less irritating than desflurane but not as favorable for induction in irritated airways. So, the inhaled anesthetic most likely to cause airway irritation during induction in smokers is desflurane.

Airway irritation from inhaled anesthetics depends on how pungent and irritant they are to the airway mucosa. Desflurane stands out because its odor is very pungent and it readily irritates the airway, provoking coughing, breath-holding, or even laryngospasm during induction. This effect is amplified in smokers, whose airways are already hyperreactive, making irritation more likely during induction with desflurane. In contrast, sevoflurane is relatively non-irritating and is commonly used for smooth inhalational induction, while isoflurane and halothane are less irritating than desflurane but not as favorable for induction in irritated airways. So, the inhaled anesthetic most likely to cause airway irritation during induction in smokers is desflurane.