CIRCULATING FLUORIDE CHANGES AND HEPATORENAL FUNCTION FOLLOWING SEVOFLURANE ANESTHESIA

Sevoflurane, a new volatile inhalational agent, undergoes biotransform ation to fluoride which is potentially nephrotoxic. We compared the ef fects of sevoflurane or isoflurane anaesthesia on hepatorenal function and serum fluoride concentrations in 50 ASA 1-3 patients undergoing m ajor intra-abdominal surgery. No patient developed renal or hepatic dy sfunction. Mean (SEM) peak fluoride concentrations were 23.1 (1.5) mu mol.l(-1) for sevoflurane and 5.4 (0.4) mu mol.l(-1) for isoflurane (p < 0.001). There was a significant correlation in the sevoflurane grou p between the total dose of agent (MAC h), the total fluoride producti on (r = 0.78, p = 0.001) and peak fluoride concentration (r = 0.57, p = 0.003). There was no correlation between these variables in the isof lurane group.