Metabolism of Isoflurane in Fischer 344 Rats and Man

Hitt, Ben A.; Mazze, Richard I.; Cousins, Michael J.; Edmunds, Henry N.; Barr, Gary A.; Trudell, James R.

doi:10.1097/00000542-197401000-00015

Cited by 49 publications

(12 citation statements)

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“…In surgical patients exposed to 3.08 2 The excretion rate of fluoride ion increased above the background excretion rate after exposure to isoflurane. Thus, higher concentrations of fluoride ion in serum were found after anesthesia with isoflurane, even though lower average doses of isoflurane than desflurane were admin- anesthetized with desflurane in the present study are compared with results from a previous study (25) where patients were anesthetized with lower average doses of isoflurane. 0.65 pmoYL.…”

Section: Discussionmentioning

confidence: 44%

Fluoride Metabolites After Prolonged Exposure of Volunteers and Patients to Desflurane

Sutton

Koblin

Gruenke

et al. 1991

Anesthesia & Analgesia

105

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We examined the metabolism of desflurane in 13 healthy volunteers given 7.35 +/- 0.81 MAC-hours (mean +/- SD) of desflurane and 26 surgical patients given 3.08 +/- 1.84 MAC-hours (mean +/- SD). Markers of desflurane metabolism included fluoride ion measured via an ion-specific electrode, nonvolatile organic fluoride measured after sodium fusion of urine samples, and trifluoroacetic acid determined by a gas chromatographic-mass spectrometric method. In both volunteer and patient groups, postanesthesia serum fluoride ion concentrations did not differ from background fluoride ion concentrations. Similarly, postanesthesia urinary excretion of fluoride ion and organic fluoride in volunteers was comparable to preanesthesia excretion rates. However, small but significant levels of trifluoroacetic acid were found in both serum and urine from volunteers after exposure to desflurane. A peak serum concentration of 0.38 +/- 0.17 mumol/L of trifluoroacetic acid and a peak urinary excretion rate of 0.169 +/- 0.107 mumol/h were detected in volunteers at 24 h after desflurane exposure. Although these increases in trifluoroacetic acid after exposure to desflurane were statistically significant, they are approximately 10-fold less than levels seen after exposure to isoflurane. Thus, desflurane strongly resists biodegradation, but a small amount is metabolized in humans.

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Section: Discussionmentioning

confidence: 44%

Fluoride Metabolites After Prolonged Exposure of Volunteers and Patients to Desflurane

Sutton

Koblin

Gruenke

et al. 1991

Anesthesia & Analgesia

105

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“…Isofluran wird oxidativ zu Trifluoressigsäure, Kohlendioxid, Fluorid und Chlorid abgebaut [12]. Bei einer Metabolisierungsrate deutlich unter 1% fallen nur sehr geringe Mengen an Trifluoressigsäure an.…”

Section: Isofluranunclassified

Volatile An�sthetika

Loscar

Conzen

2004

Der Anaesthesist

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None of the currently available inhaled anesthetics has all of the properties of an "ideal" inhaled agent. The exceptionally low solubility of desflurane and sevoflurane offers a significantly greater precision of control over maintenance of anesthesia and a potential for a more rapid recovery from anesthesia than other inhaled anesthetics. Sevoflurane appears to offer some advantages regarding cardiovascular stability. Products of metabolism or degradation can be associated with potential organ-specific toxic effects. Renal toxicity is discussed for enflurane and sevoflurane. Breakdown products of volatile agents with carbon dioxide absorbents have to be mentioned especially for sevoflurane (compound A) and desflurane (CO). In contrast to intravenous anesthetics, volatile anesthetics are associated with cardio- and cerebroprotection.

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“…In humans, the principal metabolite of isoflurane is TFA, which predominates, in addition to fluoride ion and small quantities of other unidentified organic fluorides (14). All of the identified metabolites of isoflurane are non-toxic and administration of isoflurane has not been linked with anesthetic toxicity.…”

Section: Resultsmentioning

confidence: 99%

“…Another study has been conducted demonstrating serum concentrations of TFA with known MAC hours of isoflurane, indicating that under these conditions (patients treated with isoniazid resulting in enzyme induction) the TFA concentrations are greater than 0.01 mM (15). Furthermore, the peak concentration of excreted TFA found in human urine was 1-1.3 mM (14), when patients were exposed to isoflurane at a concentration of 0.9%. Theoretically, these amounts could precondition the heart.…”

Section: Resultsmentioning

confidence: 99%