Methoxyflurane is associated with severe nephrotoxicity and death, and the author argues it should no longer be used for anesthesia.
Comment Methoxyflurane is rarely used for anesthesia because of fear, rightly so, of nephro-toxicity. Reversibility of adverse renal effects was thought to be the usual outcome of fluoride intoxication seen with the problem. However, deaths have been reported, and this article reports two clear cut cases. There is no longer a role for this drug in spite of its several admirable characteristics. Paradoxically, I suppose that one indication for use of methoxyflurane as an anesthetic could be in the case of an individual with no renal function whatsoever! It cannot get worse. Burnell R. Brown, Jr., M.D., Ph.D., F.F.A.R.C.S.
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Toomath et al. (1989) studied this question.
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