Metabolism of desflurane and isoflurane to fluoride ion in surgical patients

Smiley, Richard M.; Ornstein, Eugene; Pantuck, E. J.; Pantuck, Carol B.; Matteo, Richard S.

doi:10.1007/bf03008612

Cited by 19 publications

(8 citation statements)

References 16 publications

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“…Smiley et al (1991) measured fasting plasma F levels ranging from 3.7 to 4.6 μ mol/L. in adults (mean age 45 yrs) residing in fluoridated communities in New York [221]. From this data, it should be pointed out that the general population in fluoridated communities in the USA, have similar or higher exposure to F as workers occupationally exposed to F at a Swedish Aluminium Plant following an eight-hour work shift [222].…”

Section: Discussionmentioning

confidence: 99%

Black Tea Source, Production, and Consumption: Assessment of Health Risks of Fluoride Intake in New Zealand

Waugh¹,

Godfrey

Limeback

et al. 2017

Journal of Environmental and Public Health

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In countries with fluoridation of public water, it is imperative to determine other dietary sources of fluoride intake to reduce the public health risk of chronic exposure. New Zealand has one of the highest per capita consumption rates of black tea internationally and is one of the few countries to artificially fluoridate public water; yet no information is available to consumers on the fluoride levels in tea products. In this study, we determined the contribution of black tea as a source of dietary fluoride intake by measuring the fluoride content in 18 brands of commercially available products in New Zealand. Fluoride concentrations were measured by potentiometric method with a fluoride ion-selective electrode and the contribution of black tea to Adequate Intake (AI) and Tolerable Upper Intake Level (UL) was calculated for a range of consumption scenarios. We examined factors that influence the fluoride content in manufactured tea and tea infusions, as well as temporal changes in fluoride exposure from black tea. We review the international evidence regarding chronic fluoride intake and its association with chronic pain, arthritic disease, and musculoskeletal disorders and provide insights into possible association between fluoride intake and the high prevalence of these disorders in New Zealand.

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Section: Discussionmentioning

confidence: 99%

Black Tea Source, Production, and Consumption: Assessment of Health Risks of Fluoride Intake in New Zealand

Waugh¹,

Godfrey

Limeback

et al. 2017

Journal of Environmental and Public Health

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“…However, it is interesting to note that that AST and ALT levels were higher in sevoflurane and isoflurane treated animals compared to desflurane treated animals. Inorganic fluoride ion concentrations are known to increase during isoflurane [ 43 ] and sevoflurane [ 44 ] anesthesia compared to desflurane anesthesia, which may have had an impact on liver function as well as on AST and ALT release [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Propofol increases morbidity and mortality in a rat model of sepsis

et al. 2015

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IntroductionSevere sepsis is associated with approximately 50% mortality and accounts for tremendous healthcare costs. Most patients require ventilatory support and propofol is commonly used to sedate mechanically ventilated patients. Volatile anesthetics have been shown to attenuate inflammation in a variety of different settings. We therefore hypothesized that volatile anesthetic agents may offer beneficial immunomodulatory effects during the course of long-term intra-abdominal sepsis in rats under continuous sedation and ventilation for up to 24 hours.MethodsSham operation or cecal ligation and puncture (CLP) was performed in adult male Wistar rats followed by mechanical ventilation. Animals were sedated for 24 hours with propofol (7 to 20 mg/kg/h), sevoflurane, desflurane or isoflurane (0.7 minimal alveolar concentration each).ResultsSeptic animals sedated with propofol showed a mean survival time of 12 hours, whereas >56% of all animals in the volatile groups survived 24 hours (P <0.001). After 18 hours, base excess in propofol + CLP animals (−20.6 ± 2.0) was lower than in the volatile groups (isoflurane + CLP: -11.7 ± 4.2, sevoflurane + CLP: -11.8 ± 3.5, desflurane + CLP -14.2 ± 3.7; all P <0.03). Plasma endotoxin levels reached 2-fold higher levels in propofol + CLP compared to isoflurane + CLP animals at 12 hours (P <0.001). Also blood levels of inflammatory mediators (tumor necrosis factor-α, interleukin-1β, interleukin-10, CXCL-2, interferon-γ and high mobility group protein-1) were accentuated in propofol + CLP rats compared to the isoflurane + CLP group at the same time point (P <0.04).ConclusionsThis is the first study to assess prolonged effects of sepsis and long-term application of volatile sedatives compared to propofol on survival, cardiovascular, inflammatory and end organ parameters. Results indicate that volatile anesthetics dramatically improved survival and attenuate systemic inflammation as compared to propofol. The main mechanism responsible for adverse propofol effects could be an enhanced plasma endotoxin concentration, leading to profound hypotension, which was unresponsive to fluid resuscitation.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-015-0751-x) contains supplementary material, which is available to authorized users.

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“…Sevoflurane has the potential to adversely affect the kidney function because an inorganic fluoride ion from the defluorination of sevoflurane and compound A from reaction with carbon dioxide absorbent are associated with nephrotoxicity 14,15. On the other hand, desflurane is extremely resistant to defluorination, and it does not appear to be nephrotoxic 16. Although any nephrotoxic effect of sevoflurane in human has not yet been proven, this issue is still subject to debate due to many literatures related to sevoflurane induced nephrotoxicity 14,15,17-19.…”

Section: Introductionmentioning

confidence: 99%

Kidney Function in Living Donors Undergoing Nephrectomy by Sevoflurane or Desflurane Anesthesia

et al. 2013

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PurposeAlthough there is no clinical evidence of nephrotoxicity with the volatile anesthetics currently used in general anesthesia, a better agent should be needed in terms of preserving postoperative renal function in living kidney donors who have only single remaining kidney. The purpose of the current retrospective, single-center study was to evaluate and compare renal function of living kidney donors after nephrectomy under either sevoflurane or desflurane anesthesia.Materials and MethodsFrom January 2006 through December 2011, a total of 228 donors undergoing video assisted minilaparotomy surgery nephrectomy for kidney donation were retrospectively enrolled in the current study. The donors were categorized into a sevoflurane group or desflurane group based on the type of volatile anesthetic used. We collected laboratory data from the patients preoperatively, immediately after the operation, on the first postoperative day and on the third postoperative day. We also compared renal function of the kidney donors after donor nephrectomy by comparing creatinine level and estimated glomerular filtration rate (eGFR).ResultsThe decrease in renal function after surgery in both groups was the most prominent on the first postoperative day. There were no significant differences between the two groups in postoperative changes of creatinine or eGFR.ConclusionSevoflurane and desflurane can be used safely as volatile anesthetics in donors undergoing nephrectomy.

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Metabolism of desflurane and isoflurane to fluoride ion in surgical patients

Abstract: Metabolism of desflurane and isoflurane to fluoride ion in surgical patients

Cited by 19 publications

References 16 publications

Black Tea Source, Production, and Consumption: Assessment of Health Risks of Fluoride Intake in New Zealand

Black Tea Source, Production, and Consumption: Assessment of Health Risks of Fluoride Intake in New Zealand

Propofol increases morbidity and mortality in a rat model of sepsis

Kidney Function in Living Donors Undergoing Nephrectomy by Sevoflurane or Desflurane Anesthesia

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