Desflurane airway irritability — FRCA Primary MCQ

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ModeratePharmacologyDesflurane airway irritabilityFRCA Primary

A 46-year-old patient receives a desflurane anaesthetic. During a rapid increase in inspired concentration he coughs, breath-holds and develops sympathetic stimulation. Which property is most relevant?

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Correct answer: A — Low blood-gas solubility

Desflurane has low blood-gas solubility but is pungent and can irritate the airway, especially with rapid increases in concentration. Low solubility explains rapid onset and offset, not coughing and breath-holding. Sevoflurane is more associated with compound A concerns under specific low-flow conditions. The pearl is that desflurane is not ideal for inhalational induction.

Reference: RCoA Primary FRCA Syllabus 2026; Peck, Hill & Williams Pharmacology for Anaesthesia