Comparison of the effects of sevoflurane and halothane on the quality of anaesthesia and serum glutathione transferase alpha and fluoride in paediatric patients

Sevoflurane in Paediatric Anaesthesia

“…In a number of studies, significantly more sevoflurane than halothane recipients, or their parents, rated induction as pleasant and would have the same anaesthetic again. [75,92,98] Sevoflurane was preferred by the parents of 11 of 15 children who had received halothane for previous anaesthesia, whereas the present halothane induction was preferred by the parents of only 3 of 14 children who had also previously received halothane (p < 0.05). [98] The reason for this parental preference was not given but may have related to the lower struggling score with sevoflurane (p < 0.02) [98] (see also section 5.2.1).…”

“…In 50 children who received sevoflurane or halothane, levels of serum glutathione S-transferase α (GST; a sensitive marker of liver damage) increased significantly for up to 2 hours without evidence of hepatic dysfunction and with no difference seen between the 2 groups. [92] This suggests a possible effect on hepatic cells with both drugs. However, no such increase in GST occurred in 8 children with liver disease who were anaesthetised with sevoflurane.…”

“…Numerous, mostly comparative, trials in children demonstrate that plasma F -levels remain below the theoretical 'toxic threshold' of 50 μmol/L (for methoxyflurane) during sevoflurane anaesthesia lasting up to 9 MAC • h. [47,74,91,92,[136][137][138][139][140] Levels peak within an hour of ending anaesthesia and in most instances return to baseline within 24 hours. [47,92,[136][137][138] Plasma F -levels are significantly higher with sevoflurane than with halothane [47,48,74,92,138] or enflurane. [140] Renal impairment did not develop in any child treated with sevoflurane in these clinical trials.…”

Influência do óxido nitroso na velocidade de indução e de recuperação do halotano e do sevoflurano em pacientes pediátricos

“…Considerando-se a solubilidade dos halogenados, o sevoflurano deve apresentar maior rapidez na mudança dos planos da anestesia 5 . Entretanto, não existe consenso entre os autores de que a velocidade de indução e o tempo de despertar sejam mais rápidos nos pacientes pediátricos anestesiados com sevoflurano quando comparados ao halotano [6][7][8][9][10][11][12] . Para explicar estes resultados têm sido citados fatores tais como a diferente contribuição do N 2 O na CAM do sevoflurano e do halotano e a utilização destes dois halogenados com múlti-plos de CAM não comparáveis.…”

Glutathione S-transferase as a toxicity indicator in general anesthesia: genetics and biochemical function

“…Similarly, prolonged isoflurane anesthesia did not cause any differences in the levels of GST B1 and B2 in the liver [22]. General anesthesia with sevoflurane and halothane administered to children as well as with desflurane and sevoflurane low flows in elderly patients resulted in the increase of the α-GST concentration in the serum, which returned to normal within 24 hours [23,24]. Higher sensitivity of α-GST as a hepatic indicator, compared with aminotransferases (ALT and AST), was also shown by Yousif et al [25] in his studies on sevoflurane in a group of patients with induced hypotension and without hypotension.…”