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A Multicenter Study Evaluating the Effects of Sevoflurane on Renal Function in Patients With Renal Insufficiency
- Source :
- Journal of Cardiovascular Pharmacology and Therapeutics. 3:229-234
- Publication Year :
- 1998
- Publisher :
- SAGE Publications, 1998.
-
Abstract
- Background: This multicenter study was undertaken to compare the effect of sevoflurane with that of isoflurane on renal function in 26 patients with pre-existing renal insufficiency. Sevoflurane undergoes hepatic metabolism, with release of inorganic fluoride. Elevated flu oride levels have been associated with renal impairment in patients undergoing methoxyflu rane anesthesia raising concerns about the nephrotoxic potential of sevoflurane. Methods : Patients were ASA II or III class, with renal insufficiency defined by a preopera tive serum creatinine concentration of 1.5-3.0 mg/dl. A standardized anesthetic regimen was used consisting of intravenous induction with propofol, vecuronium for muscle relax ation, and fentanyl for analgesia. Patients were randomized to receive either isoflurane or sevoflurane with 100% oxygen. Blood samples were obtained preoperatively and at 24, 48, and 72 h postoperativety for renal/electrolyte determinations. Blood samples for plasma flu oride measurement were obtained preoperatively. Results: Plasma fluoride levels were significantly higher in patients receiving sevoflurane at all measurement points from 0 to 72 h postanesthesia. Mean peak fluoride concentration was 33.4 μM. The maximum fluoride value measured was 51.2 μM. There were no signifi cant differences in postoperative serum creatinine values at any time between patients receiving sevoflurane or isoflurane. Conclusions: Sevoflurane metabolism produces elevations in plasma fluoride concentra tions relative to isoflurane. Despite the increase in plasma fluoride levels, the administration of sevoflurane to patients with renal insufficiency did not produce any adverse effects on renal function as measured by serum creatinine concentration when compared with isoflurane.
- Subjects :
- Pharmacology
Creatinine
business.industry
Renal function
030204 cardiovascular system & hematology
Sevoflurane
Fentanyl
Nephrotoxicity
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
chemistry
Isoflurane
Anesthesia
Anesthetic
medicine
Pharmacology (medical)
030212 general & internal medicine
Cardiology and Cardiovascular Medicine
business
Propofol
medicine.drug
Subjects
Details
- ISSN :
- 19404034 and 10742484
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiovascular Pharmacology and Therapeutics
- Accession number :
- edsair.doi.dedup.....c282f784e1b596ef847a897ce456accc