In this tutorial we review the modern volatile anesthetic agents used in everyday anesthesia practice: sevoflurane, desflurane and isoflurane. We begin by explaining the key pharmacological concepts that every anesthesia trainee should understand, including blood-gas partition coefficient, oil-gas partition coefficient, tissue-blood partition coefficient, potency, onset of action, emergence, and minimum alveolar concentration (MAC). We also show how MAC is applied in routine clinical practice to achieve and maintain an appropriate depth of anesthesia.

The tutorial then compares the three commonly used volatile agents, highlighting their individual advantages and limitations, including speed of induction and recovery, metabolism, pungency, suitability for inhalational induction, and low-flow anesthesia. Finally, we examine their physiological effects on the brain, spinal cord, respiratory system, cardiovascular system, and other organ systems, explaining why these effects matter during routine anesthesia.