Renal Concentrating Function with Prolonged Sevoflurane or Enflurane Anesthesia in Volunteers
| Autor: | T. Philip Malan, R. Joseph Isner, Elizabeth A. Brown, Scott E. Morgan, Burnell R. Brown, Edward J. Frink |
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| Rok vydání: | 1994 |
| Předmět: |
Adult
Male Methyl Ethers Time Factors Renal function Kidney Sevoflurane Enflurane Fluorides chemistry.chemical_compound Reference Values Acetylglucosaminidase medicine Humans Deamino Arginine Vasopressin Desmopressin Volunteer Anesthetics Creatinine business.industry Anesthesiology and Pain Medicine chemistry Anesthesia Renal physiology Anesthetic Anesthesia Inhalation business Ethers medicine.drug |
| Zdroj: | Anesthesiology. 80:1019-1025 |
| ISSN: | 0003-3022 |
| DOI: | 10.1097/00000542-199405000-00011 |
| Popis: | BACKGROUND Sevoflurane, a new inhalational anesthetic, is biotransformed, producing peak plasma inorganic fluoride concentrations that may exceed 50 microM. We evaluated plasma inorganic fluoride concentrations with prolonged (> 9 MAC-h) sevoflurane or enflurane anesthesia in volunteers and compared renal concentrating function with desmopressin testing 1 and 5 days after anesthesia. METHODS Fourteen healthy male volunteers received either enflurane or sevoflurane (1-1.2 MAC) for more than 9 MAC-h. Each volunteer was administered three tests of renal concentrating function, with intranasal desmopressin and urine collections performed 1 week before anesthesia and 1 and 5 days after anesthesia. Venous blood samples were obtained for plasma fluoride concentrations during and after anesthesia. Creatinine clearance was determined by 24-h urine collections 7 days before and 4 days after anesthesia. Urine samples were obtained before and 1, 2, and 5 days after anesthesia for determination of n-acetyl-beta-glucosaminidase and creatinine concentrations. RESULTS Prolonged sevoflurane anesthesia (9.5 MAC-h) did not impair renal concentrating function on day 1 or 5 postanesthesia, as determined by desmopressin testing. Maximal urinary osmolality on day 1 postanesthesia was decreased (< 800 mOsm/kg) in two of seven enflurane-anesthetized volunteers; however, mean results did not differ from the those of the sevoflurane group. Mean peak plasma fluoride ion concentrations were 23 +/- 1 microM 6 h postanesthesia for enflurane and 47 +/- 3 microM at the end of anesthesia for sevoflurane (P < 0.01). There were no changes in creatinine clearance or urinary n-acetyl-beta-glucosaminidase concentration in either anesthetic group. DISCUSSION Prolonged sevoflurane anesthesia did not impair renal concentrating function, as evaluated with desmopressin testing 1 and 5 days postanesthesia in healthy volunteers. Although with prolonged enflurane anesthesia, mean maximal osmolality values on day 1 postanesthesia did not differ from sevoflurane values, there was evidence in two volunteers at this time point of impairment in renal concentrating function, which normalized 5 days postanesthesia. These results occurred despite a higher peak plasma fluoride ion concentration and greater total inorganic fluoride renal exposure with sevoflurane anesthesia. |
| Databáze: | OpenAIRE |
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