- Poster presentation
- Open Access
Four-day sedation using sevoflurane: fluoride and renal function
- Published: 1 March 2010
Keywords
- Sevoflurane
- Sufentanil
- Volatile Anesthetic
- Methoxyflurane
- Renal Volume
Introduction
Volatile anesthetics for sedation in the ICU are currently undergoing a revival, mainly due to the recent availability of a novel delivery system, the anesthetic conserving device (ACD). Cytochrome P450 metabolic degradation of isoflurane and sevoflurane leads to the generation of inorganic fluoride and hexafluoro isopropanol. Historically, data derived from methoxyfluorane defined a fluoride nephrotoxicity threshold of 50 μmol/l. Therefore, we investigated the feasibility and safety, focusing on kidney function, of 4-day sevoflurane-ACD sedation.
Methods
Approval of the State Ethics Committee was obtained. Visceral surgical patients either received sedation via sevoflurane-ACD (n = 20) or were intravenously sedated (sufentanil, propofol, n = 20). Serum fluoride, renal, liver, pulmonary, cardiovascular function and depth of sedation were measured.
Results
Figure 1
Conclusions
Inhalational sevoflurane sedation subsequently leads to a transient, marked increase of serum fluoride concentrations. The methoxyflurane fluoride nephrotoxicity threshold was largely surpassed without apparent deleterious effect on renal volume regulation and detoxification. The sedational use of the volatile anesthetic sevoflurane up to 4 days is safe and feasible.
Authors’ Affiliations
References
- Roehm , et al.: Anesth Analg. 2009, 108: 1848-5184. 10.1213/ane.0b013e3181a1988bView ArticleGoogle Scholar