Abstract
We studied the correlation between renal function and pharmacokinetic parameters of inorganic fluoride following sevoflurane anesthesia. In 30 neurosurgical patients aged 40–70 years, anesthesia was induced with midazolam and sevoflurane and maintained with sevoflurane and nitrous oxide in oxygen. Serum and urine inorganic fluoride (F−) levels and β2-microglobulin (BMG), blood urea nitrogen (BUN), and serum creatinine (Cr) were measured during and after anesthesia. The decrease rate of serum F− level and the area under the curve (AUC) of serum F− were calculated. Correlations among sevoflurane dosage, duration of administration, peak serum F− level, AUC, the decrease rate of serum F− level, and the maximum values in BUN, Cr, and urine BMG during the study were investigated. Urine BMG increased significantly after surgery but returned to the preoperative level in a week. BUN, Cr, and serum BMG remained within normal ranges during the study. Sevoflurane dosage and duration of administration were significantly correlated with AUC and the maximum value of urine BMG, but not with the peak serum F− level or the decrease rate of serum F−. AUC was significantly correlated with the maximum value of urine BMG. In sevoflurane anesthesia, sevoflurane dosage, duration of administration, and AUC affected urine BMG level, but not peak serum F−.
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References
Holaday DA, Smith FR (1981) Clinical characteristics and biotransformation of sevoflurane in healthy human volunteers. Anesthesiology 54:100–106
Cook TL, Beppu WJ, Hitt BA, Kosec JC, Mazze RI (1975) Renal effects of and metabolism of sevoflurane in Fisher 344 rats. Anesthesiology 43:70–77
Kobayashi Y, Ochiai R, Takeda J, Sekiguchi H, Fukushima K (1992) Serum and urinary inorganic fluoride concentration after prolonged inhalation of sevoflurane in humans. Anesth Analg 74:753–757
Frink ER Jr, Ghantous AJ, Malan TP, Morgan S, Fernando J, Gandolfi AJ, Brown BR Jr (1992) Plasma inorganic fluoride with sevoflurane anesthesia: correlation with indices of hepatic and renal function. Anesth Analg 74:231–235
Mazze RI, Shue GL, Jackson SH (1971) Renal dysfunction associated with methoxyflurane anesthesia. A randomized, prospective clinical evaluation. JAMA 216:278–288
Cousins MJ, Mazze RI (1973) Methoxyflurane nephrotoxicity. A study of dose response in man. JAMA 225:1611–1616
Martis L, Lynch S, Napoli MD, Wood EF (1981) Biotransformation of sevoflurane in dogs and rats. Anesth Analg 60:186–191
Holaday DA, Fiserova-Bergerova V (1979) Fate of fluorinated metabolites of inhalational anesthetics in man. Drug Metabol Rev 9:61–78
Davidkova T, Fujii K, Kikuchi H, Horibe M, Mukaida K, Sato N, Kawachi S, Morio M (1987) Defluorination of sevoflurane in clinical patients. Hiroshima J Anesth 23:99–106
Kumano H, Osaka S, Ishimura N, Nishiwada M (1992) Effects of enflurane, isoflurane, and sevoflurane on renal tubular functions (in Japanese with English abstract). Masui (Jpn J Anesthesiol) 41:1735–1740
Kanematsu T (1990) Effects of seyoflurane on renal form and function (in Japanese with English abstract). Nichidai-ishi (J Nihon Univ Med Assn) 49:135–143
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Nishiyama, T., Toda, N. Correlation between renal function and pharmacokinetic parameters of inorganic fluoride following sevoflurane anesthesia. J Anesth 9, 125–128 (1995). https://doi.org/10.1007/BF02479842
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DOI: https://doi.org/10.1007/BF02479842