Comparison of maintenance and recovery characteristics of sevoflurane-nitrous oxide and enflurane-nitrous oxide anaesthesia.
We compared maintenance of anaesthesia and recovery using either sevoflurane or enflurane anaesthesia in ASA I-III patients undergoing surgery with an anticipated minimum duration of 3 h. Serum fluoride concentrations were also measured to assess the potential for renal toxicity. After induction of anaesthesia with thiopentone, patients received, for maintenance, either 1.5% end-tidal sevoflurane (0.73 MAC) with N2O 58% (0.58 MAC) (n = 40) or 1.2% end-tidal enflurane (0.7 MAC) with N2O 57% (0.57 MAC) (n = 40). Other drugs administered during anaesthesia were similar in all groups. Haemodynamic measurements, recovery times, as well as post-operative nausea and vomiting were comparable in both groups. The mean peak plasma inorganic fluoride ion concentrations were reached 4 h after operation in both groups (27.7 microM L-1 for sevoflurane and 16.75 microM L-1 for enflurane, P < 0.05) declining 50% within 24 h in both groups. A positive correlation (P < 0.05) was found between anaesthetic exposure (MAC h) and fluoride concentrations in the two groups. Sevoflurane anaesthesia resulted in similar haemodynamic stability, recovery times and post-operative side effects as enflurane anaesthesia, but produced significantly greater serum fluoride levels.
Galicia General Hospital, University of Santiago, School of Medicine, Spain.
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Blanco
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Vidal
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Blanco
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Fagundo
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Campaña
J
J
Alvarez
D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D004737:Enflurane / Q000009:adverse effects; D004987:Ethers / Q000009:adverse effects; D005459:Fluorides / Q000097:blood; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000473:pathology; D008738:Methyl Ethers; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use; D009609:Nitrous Oxide / Q000009:adverse effects; D011184:Postoperative Period; D000077149:Sevoflurane
D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D004987:Ethers; D008738:Methyl Ethers; D000077149:Sevoflurane; D009020:Morphine; D004737:Enflurane; D009609:Nitrous Oxide; D005459:Fluorides