Medical Pharmacology Chapter 14:  Physics and Anesthesiology

Anesthetic Circuitry

 

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  • 23Compound A, a metabolite of sevoflurane (Sevorane, Ultane), has been suggested to be a renal toxin.

  • Endpoints of renal toxicity might include abnormal albumin excretion, urinary glucose, and alpha-glutathione-S-transferase. 

    • Using these endpoints, compound A at doses < 240 ppm/hour did not induce abnormal levels of the aforementionned compounds.  By contrast, patients receiving doses > 240 ppm/hour exhibited increased, abnormal excretion of urinary albumin, glucose, and glutathione-S-transferase. 

    • In terms of relating these results to sevoflurane (Sevorane, Ultane) administration, Compound A levels exceeding 240 ppm//hour might be expected following prolonged sevoflurane (Sevorane, Ultane) anesthesia, for example eight hours at 2L/min flowrate. 

    • This administration corresponds to about 30 ppm Compound A exposure .which would then be expected or could produce a transient albuminuria and enzymuria in otherwise healthy patients

 

Dessicated Absorbents will degrade these Anesthetics

Enflurane (Ethrane)

Desflurane (Suprane)

Isoflurane (Forane)

 

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