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Minimal flow sevoflurane and isoflurane anaesthesia and impact on renal function

Published online by Cambridge University Press:  16 August 2006

C. Goeters ,
C. Reinhardt ,
E. Gronau ,
R. Wüsten ,
T. Prien ,
J. Baum ,
S. Vrana  and
H. Van Aken
C. Goeters
Affiliation:
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin der Westfälischen Wilhelms-Universität Münster, Germany
C. Reinhardt
Affiliation:
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin der Westfälischen Wilhelms-Universität Münster, Germany
E. Gronau
Affiliation:
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin der Westfälischen Wilhelms-Universität Münster, Germany
R. Wüsten
Affiliation:
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin der Westfälischen Wilhelms-Universität Münster, Germany
T. Prien
Affiliation:
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin der Westfälischen Wilhelms-Universität Münster, Germany
J. Baum
Affiliation:
Abteilung fur Anästhesie und Intensivmedizin des St. Elisabeth-Stiftes Damme, Germany
S. Vrana
Affiliation:
Klinik für Anästhesiologie der Johannes-Gutenberg-Universität Mainz, Germany
H. Van Aken
Affiliation:
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin der Westfälischen Wilhelms-Universität Münster, Germany
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Abstract

Background and aim Compound A generation and accumulation in sevoflurane anaesthesia is dependent on fresh gas flow. We investigated the extent of generation of compound A.

Methods After Institutional Review Board approval and informed consent, patients with normal renal function were randomized to receive either sevoflurane (n = 33) or isoflurane (n = 43) minimal flow anaesthesia (0.5 L min−1) for at least 2 h under standardized conditions. Compound A concentrations were quantified and blood and urine samples were taken to assess renal involvement. Both groups were comparable.

Results No significant differences concerning blood chemistry and urine measurements were found. The maximum mean compound A concentration was observed 90 min after flow reduction being 40±9p.p.m. at a corresponding mean sevoflurane concentration of 2.1 ±0.5 vol%. Mean inspiratory compound A exposure was 102±l33p.p.mh−1.

Conclusion Compound A concentrations using 0.5 L min−1 fresh gas flow and a heated absorber were higher than previously published values using an inflow of 1 Lmin−1. Compound A exposure was similar to other clinical studies which did not show changes in renal and hepatic function.

Keywords

gasescardon dioxidepoisoninggas poisoningcompound Aanaesthesiageneralinhalationclosed-circuitintraoperative complicationsbiodegradation
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 18 , Issue 1 , January 2001 , pp. 43 - 50
Copyright
2001 European Society of Anaesthesiology

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