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Essay / Research Paper Abstract
10 pages in length. Past issues with inhalant anesthetics and renal toxicity were not readily recognized due to the limited amount of information available on the precarious combination; today, however, the vast research that has been conducted pertaining to this topic has presented myriad data that renders a substantial relationship between the use of such inhalant anesthetics as methoxyflurane and the propensity toward renal toxicity. Bibliography lists 10 sources.
Page Count:
10 pages (~225 words per page)
File: LM1_TLCinhal.rtf
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that has been conducted pertaining to this topic has presented myriad data findings that indicate a substantial relationship between the use of such inhalant anesthetics as methoxyflurane and sevoflurane, and
the propensity toward renal toxicity during surgery. "Despite the recent interest and advances in intravenous anaesthetics, opioids, and infusion techniques, the vast majority of general anaesthetics continue to involve
primarily inhalational agents" (Inhalation Agents: New Drugs, New Gas Flows). II. HISTORY & CELLULAR/BIOCHEMICAL BASIS Past problems with renal toxicity caused by inhalant anesthetics was primarily due to the
inefficiency of methoxyflurane, which was responsible for high output renal failure with increased BUN and serum creatinine. Research has linked the release of inorganic fluorides to the bodys ability
to metabolize methoxyflurane. "The fluoride liberated during methoxyflurane anaesthesia appeared to be produced in the kidney and was able to cause the damage directly. Sevoflurane is metabolised four times
less readily in the kidney with lower fluoride levels within the kidney" (Volatile Anaesthetics). The following dependencies exist with regard to the necessary amount of methoxyflurane before renal toxicity
occurs: * No effects: < 40 um/L * Subclinical effects: 50-80 um/L * Clinical toxicity: > 80 um/L * Convention: renal toxicity may occur at concentrations
above 50 um/L; not absolute indication, e.g. renal toxicity is not observed at 50 um/L following enflurane (Ethrane) or sevoflurane (Sevorane, Ultane) (Renal Effects-Volatile Anesthetics: Overview).
Interestingly, the use of other inhalant anesthetics such as isoflurane, enflurane and sevoflurane was not associated with renal toxicity, inasmuch as methoxyflurane "is metabolized to a
significant degree in the kidney whereas the other inhalation agents undergo mainly hepatic biotransformation" (Review of Currently Used Inhalation Anesthetics; Part II). Research has indicated that the location of
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