Why the study?
Does sevoflurane anaesthesia increase serum fluoride concentrations or affect hepatorenal function compared to isoflurane in ASA 1-3 patients undergoing major intra-abdominal surgery?
Does sevoflurane anaesthesia increase serum fluoride concentrations or affect hepatorenal function compared to isoflurane in ASA 1-3 patients undergoing major intra-abdominal surgery?
Sevoflurane anesthesia produces higher serum fluoride concentrations than isoflurane, which correlates with dose, but does not cause acute hepatorenal dysfunction.
Higher fluoride with sevoflurane occurred without acute hepatorenal dysfunction; leaves open questions on long-term safety in wider populations.
Sevoflurane, a new volatile inhalational agent, undergoes biotransformation to fluoride which is potentially nephrotoxic. We compared the effects of sevoflurane or isoflurane anaesthesia on hepatorenal function and serum fluoride concentrations in 50 ASA 1-3 patients undergoing major intra-abdominal surgery. No patient developed renal or hepatic dysfunction. Mean (SEM) peak fluoride concentrations were 23.1 (1.5) mumol.l-1 for sevoflurane and 5.4 (0.4) mumol.l-1 for isoflurane (p < 0.001). There was a significant correlation in the sevoflurane group between the total dose of agent (MAC h), the total fluoride production (r = 0.78, p = 0.0001) and peak fluoride concentration (r = 0.57, p = 0.003). There was no correlation between these variables in the isoflurane group.
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Newman et al. (1994) studied this question.
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