Plasma Inorganic Fluoride Concentrations after Sevoflurane Anesthesia in Children

Levine, Mark; Sarner, J. B.; Lerman, Jerrold; Davis, Peter J.; Sikich, Nancy; Maloney, Karen; Motoyama, Etsuro K.; Cook, David

doi:10.1097/00000542-199602000-00012

Cited by 37 publications

(15 citation statements)

References 20 publications

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“…It is unlikely that changes in renal function would have been detected at this time. Following sevoflurane anaesthesia in children (average 2-3 MAC-hours) peak fluoride levels up to 20 microM have been measured within one hour of completion of anaesthesia, but concentrations rapidly reduce over the subsequent 24 hours without measured changes in renal function 1,5,14 . In paediatric practice, the use of T piece systems avoids any potential concerns regarding the degradation of sevoflurane in carbon dioxide absorbents.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Sevoflurane with Halothane for Paediatric Day Case Surgery

Walker

Haugen

Richards

1997

Anaesth Intensive Care

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A phase III, open label, randomized study was conducted in 50 patients comparing halothane and sevoflurane for paediatric day case surgery. A graded inhalational induction resulted in only slightly more rapid induction with sevoflurane (3.34±0.92 versus 3.85±1.02 minutes; P>0.05). In children receiving sevoflurane, systolic blood pressure decreased to a lesser extent during induction (14.3±19.2 versus 26.9±10.9 percent decrease from resting values; P<0.01) and heart rate was maintained. Respiratory events (coughing, breath-holding, bronchospasm, laryngospasm) were more common during induction with halothane, and excitement more common in children receiving sevoflurane. Emergence times were significantly more rapid in children who had received sevoflurane (21.4±10.9 versus 33.1 ±13.7 minutes; P<0.01). Objective pain/discomfort scores were higher in patients receiving sevoflurane at 10, 20, 30 and 40 minutes after arrival in the recovery room, and the incidence of excitement during emergence was higher in this group. It is concluded that sevoflurane is well tolerated for inhalational induction and has an improved cardiovascular profile compared to halothane. Emergence was significantly more rapid following sevoflurane.

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Section: Discussionmentioning

confidence: 99%

A Comparison of Sevoflurane with Halothane for Paediatric Day Case Surgery

Walker

Haugen

Richards

1997

Anaesth Intensive Care

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“…Therefore, studies were conducted to determine inorganic fluoride levels in infants and children. Inorganic fluoride concentrations were approximately half those seen in adults following comparable exposures to sevoflurane (144,180,181,183,259). In another study, both inorganic fluoride and compound A levels were measured in 19 children following exposure to 2 L/min sevoflurane (94).…”

Section: Renal and Hepatic Effectsmentioning

confidence: 92%

Sevoflurane: Approaching the Ideal Inhalational Anesthetic A Pharmacologic, Pharmacoeconomic, and Clinical Review

2001

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Sevoflurane is a safe and versatile inhalational anesthetic compared with currently available agents. Sevoflurane is useful in adults and children for both induction and maintenance of anesthesia in inpatient and outpatient surgery. Of all currently used anesthetics, the physical, pharmacodynamic, and pharmacokinetic properties of sevoflurane come closest to that of the ideal anesthetic (200). These characteristics include inherent stability, low flammability, non-pungent odor, lack of irritation to airway passages, low blood:gas solubility allowing rapid induction of and emergence from anesthesia, minimal cardiovascular and respiratory side effects, minimal end-organ effects, minimal effect on cerebral blood flow, low reactivity with other drugs, and a vapor pressure and boiling point that enables delivery using standard vaporization techniques. As a result, sevoflurane has become one of the most widely used agents in its class.

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“…Numerous, mostly comparative, trials in children demonstrate that plasma F -levels remain below the theoretical 'toxic threshold' of 50 μmol/L (for methoxyflurane) during sevoflurane anaesthesia lasting up to 9 MAC • h. [47,74,91,92,[136][137][138][139][140] Levels peak within an hour of ending anaesthesia and in most instances return to baseline within 24 hours. [47,92,[136][137][138] Plasma F -levels are significantly higher with sevoflurane than with halothane [47,48,74,92,138] or enflurane. [140] Renal impairment did not develop in any child treated with sevoflurane in these clinical trials.…”

Section: Inorganic Fluoride Ionsmentioning

confidence: 99%

Sevoflurane in Paediatric Anaesthesia

Goa¹,

Noble²,

Spencer³

1999

Pediatric Drugs

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Sevoflurane is a preferred anaesthetic agent for induction and maintenance of paediatric anaesthesia because of its rapid induction and recovery characteristics, lack of pungency and agreeable odour, and acceptable cardiovascular profile. Although the issue of postoperative excitement requires clarification, sevoflurane anaesthesia can be considered a rational choice for ambulatory and nonambulatory surgery in children.

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Plasma Inorganic Fluoride Concentrations after Sevoflurane Anesthesia in Children

Abstract: It was concluded that, during the 24 h after 2.7 +/- 1.6 MAC x h sevoflurane, the peak recorded [F-] is low (15.8 microns), F- is eliminated rapidly, and children are unlikely to be at risk of nephrotoxicity from high [F-].

Cited by 37 publications

References 20 publications

A Comparison of Sevoflurane with Halothane for Paediatric Day Case Surgery

A Comparison of Sevoflurane with Halothane for Paediatric Day Case Surgery

Sevoflurane: Approaching the Ideal Inhalational Anesthetic A Pharmacologic, Pharmacoeconomic, and Clinical Review

Sevoflurane in Paediatric Anaesthesia

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