title: A comparison of the effects of prolonged (>10 hour) low-flow sevoflurane, high-flow sevoflurane, and low-flow isoflurane anaesthesia on hepatorenal function in orthopaedic patients.
abstract: This study compared the effects of low-flow sevoflurane, high-flow sevoflurane and low-flow isoflurane on hepatorenal function during and after more than 10 hours of anaesthesia. Twenty-five patients scheduled for elective orthopaedic surgery were categorized into three groups; low-flow sevoflurane (fresh gas flow at 1 litre/min, n = 9), high-flow sevoflurane (5 l/rmin, n = 7), or low-flow isoflurane (1 l/min, n=9). Inspiratory compoundA concentrations were measured. The groups had similar duration of anaesthesia and exposure to anaesthetic agents. The area under the curve of concentration (mean, SD) of compound A in the low-flow sevoflurane group (359.8, 106.1 ppm.h) was greater than that in the high-flow sevoflurane group (61.1, 29.3 ppm.h; P<0.01). All groups showed normal plasma creatinine and creatinine clearance, and transient postoperative increases in plasma alanine aminotransferase and alpha glutathione-S-transferase, as well as urinary glucose and alpha glutathione-S-transferase, with no significant differences between groups. There were no significant relationships between the area under the curve of concentration of compound A and the biomarkers. These findings suggest that prolonged anaesthesia with low-flow sevoflurane has similar effects on hepatorenal function to prolonged anaesthesia with high-flow sevoflurane and low-flow isoflurane.
authors.affiliation: Department of Anesthesiology and Critical Care, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Fukuda
authors.forename: M
authors.initials: M
authors.lastname: Kawamoto
authors.forename: O
authors.initials: O
authors.lastname: Yuge
authors.forename: K
authors.initials: K
authors.lastname: Fujii
mesh_terms: D000328:Adult; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000494:pharmacology; D015415:Biomarkers / Q000032:analysis; D002849:Chromatography, Gas; D004987:Ethers / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D006530:Hepatorenal Syndrome / Q000139:chemically induced*; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000008:administration & dosage / Q000494:pharmacology; D007530:Isoflurane / Q000008:administration & dosage / Q000494:pharmacology; D007668:Kidney / Q000187:drug effects / Q000502:physiology; D007677:Kidney Function Tests; D008099:Liver / Q000187:drug effects / Q000502:physiology; D008111:Liver Function Tests; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage / Q000494:pharmacology; D000077149:Sevoflurane; D013524:Surgical Flaps; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D015415:Biomarkers; D004987:Ethers; D006845:Hydrocarbons, Fluorinated; D008738:Methyl Ethers; D000077149:Sevoflurane; C078742:fluoromethyl 2,2-difluoro-1-(trifluoromethyl)vinyl ether; D007530:Isoflurane