Recent pre-clinical and clinical studies have shown that the properties of the new aqueous preparation of the anaesthetic steroid alphaxalone (Phaxan™) are exactly the same as those described previously for the CremophorEL formulation of alphaxalone, (Althesin®) that was used extensively in clinical anaesthetic practice from 1972-1984; the same speed of onset and duration of anaesthesia and sedation, very high safety profile but without the CremophorEL-induced hypersensitivity. These results strongly suggest that Phaxan™ will have the same clinical profile and utility as Althesin® sans hypersensitivity reactions
When Althesin was being marketed and used clinically, one sub specialty of anaesthetic practice was markedly changed by the introduction of the agent; neuroanaesthesia. The big advantages of Althesin® in this field of practice were the cardiovascular stability and fast predictable awakening, a powerful anticonvulsant effect combined with the drug’s ability to control cerebral metabolic rate and intracranial pressure.
What follows below is a review of published data that point to the properties, effects and uses that can be expected from using Phaxan™ in the place of Althesin® for anaesthesia and sedation in neurosurgery and neuro-intensive care.