Minimal flow sevoflurane and isoflurane anaesthesia and impact on renal function.
OBJECTIVE
Compound A generation and accumulation in sevoflurane anaesthesia is dependent on fresh gas flow. We investigated the extent of generation of compound A.


METHODS
After Institutional Review Board approval and informed consent, patients with normal renal function were randomized to receive either sevoflurane (n = 33) or isoflurane (n = 43) minimal flow anaesthesia (0.5 L min-1) for at least 2 h under standardized conditions. Compound A concentrations were quantified and blood and urine samples were taken to assess renal involvement. Both groups were comparable.


RESULTS
No significant differences concerning blood chemistry and urine measurements were found. The maximum mean compound A concentration was observed 90 min after flow reduction being 40 +/- 9 p.p.m. at a corresponding mean sevoflurane concentration of 2.1 +/- 0.5 vol%. Mean inspiratory compound A exposure was 102 +/- 33 p.p.m h-1.


CONCLUSIONS
Compound A concentrations using 0.5 L min-1 fresh gas flow and a heated absorber were higher than previously published values using an inflow of 1 L min-1. Compound A exposure was similar to other clinical studies which did not show changes in renal and hepatic function.
Goeters
C
C
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälischen Wilhelms-Universität Münster, Germany.
Reinhardt
C
C
Gronau
E
E
Wüsten
R
R
Prien
T
T
Baum
J
J
Vrana
S
S
Van Aken
H
H
D000328:Adult; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D007530:Isoflurane