Which anesthetic agent requires adjustment in concentration at higher altitudes, unlike others?

Desflurane is the anesthetic agent that requires adjustment in concentration at higher altitudes due to its low solubility and the influence of atmospheric pressure on its partial pressure. At higher altitudes, the lower atmospheric pressure reduces the partial pressure of all gases, including desflurane. Since anesthetic agents act by achieving a certain partial pressure in the brain, adjustments need to be made to the concentration of desflurane to maintain the desired anesthetic effect.

In contrast, halothane, isoflurane, and sevoflurane are generally more soluble in blood and tissues, which leads to a different pharmacodynamic profile. While they also may be affected by changes in atmospheric pressure, desflurane's unique properties make it particularly sensitive to altitude changes. This necessitates careful monitoring and potential adjustments to ensure effective anesthesia at higher elevations, where lower atmospheric pressures can compromise the delivery of the anesthetic agent.