A 60-year-old man with moderate hepatic dysfunction is scheduled for abdominal surgery. Which inhalational agent is MOST appropriate because it undergoes the least hepatic metabolism among the fluorinated agents?

• A Halothane
• B Enflurane
• C Sevoflurane
• D Desflurane ✓

Explanation

Desflurane undergoes minimal biotransformation (~0.02%), making it the safest fluorinated inhalational agent in patients with pre-existing hepatic disease. Halothane undergoes ~20% hepatic metabolism and is associated with halothane hepatitis. Enflurane (~2%) and sevoflurane (~3–5%) also undergo significantly more metabolism than desflurane, producing potentially hepatotoxic metabolites.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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