Desflurane Induction Unsuitability — FRCA Primary MCQ
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Correct answer: B — It is indicated for inhalational induction in children
Explanation lettering: B = shown as A · E = shown as B · A = shown as D · D = shown as E
E is incorrect. Desflurane is not indicated for inhalational induction in children because it frequently causes coughing, breath-holding, apnoea, laryngospasm and increased salivation. These airway effects also make statement A correct. Its blood:gas partition coefficient is approximately 0.42 and its boiling point is 22.8°C, so B and C are correct. MAC is age-dependent: in oxygen it is approximately 7.3% at 25 years, 6.0% at 45 years and 5.2% at 70 years, making D correct. Desflurane is licensed for induction in adults, although breathing it while awake is poorly tolerated; therefore, the original explanation's blanket statement that it is unsuitable for all inhalational induction was too broad.
Reference: Piramal Critical Care Ltd. Desflurane 100% (v/v) Inhalation Vapour, liquid, Summary of Product Characteristics, sections 4.1, 4.2, 4.3 and 5.1, updated 2024. https://www.medicines.org.uk/emc/product/10799/smpc