Effects of Chronic Inhalation of Halothane, Enflurane or Isoflurane in Rats

Plummer, John L.; Hall, Pauline de la Μ.; Jenner, Mark A.; Ilsley, A. H.; Cousins, Michael J.

doi:10.1093/bja/58.5.517

Cited by 25 publications

(9 citation statements)

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“…Halothane is thought to act as a suicide substrate for P-450 with metabolites that inhibit P-450 (38) whereas barbiturates induce P-450 (39). In contrast, isoflurane (which was used in this study) does not alter hepatic microsomal cytochrome P-450 (40). Furthermore, since isoflurane was given to septic as well as shamoperated animals, it is unlikely that the reduction of hepatic CYP1A2 gene expression and protein concentrations in sepsis is due to the use of this anesthetic.…”

Section: Discussionmentioning

confidence: 95%

Down-regulation of hepatic CYP1A2 plays an important role in inflammatory responses in sepsis

Crawford

Yang

Zhou

et al. 2004

Critical Care Medicine

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Section: Discussionmentioning

confidence: 95%

Down-regulation of hepatic CYP1A2 plays an important role in inflammatory responses in sepsis

Crawford

Yang

Zhou

et al. 2004

Critical Care Medicine

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“…The potential adverse effects of volatile anaesthetics have been the subject of several reports that linked exposure to the occurrence of adverse health effects [21][22][23][24][25][26][27][28][29][30][31][32] . However, many of these studies suffer from methodological flaws and, until now, no direct causal relationship has been demonstrated unequivocally.…”

Section: Discussionmentioning

confidence: 99%

Occupational exposure to sevoflurane during cardiopulmonary bypass

2011

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Volatile anaesthetic agents are widely used for maintenance of anaesthesia in all kinds of surgical procedures. Despite the implementation of measures such as adequate ventilation of the operating room and the use of efficient scavenging systems, concern remains about the risks for occupational exposure, especially in situations associated with an increased risk of anaesthetic gas waste, such as with the use of volatile anaesthetic agents on cardiopulmonary bypass. The present contribution reports the results of a preliminary safety assessment involving measurements of sevoflurane concentrations in the ambient air of a cardiac surgery operating room. In 22 cardiac surgical procedures with cardiopulmonary bypass (11 with open and 11 with closed venous reservoir), measurements of trace concentrations were obtained every 10 min at the following sites: at the outlet of the oxygenator, at the outlet of the cardiotomy reservoir, in the breathing zone of the perfusionist and above the surgical field. The concentrations were measured on-line using a photoacoustic infrared spectrometer. Mean sevoflurane waste concentrations remained consistently below the recommended target value of 4.68 ppm throughout the observation period at the different measurement sites. These results indicate that, with the use of sevoflurane on cardiopulmonary bypass, the recommended levels for occupational exposure are not exceeded, provided adequate operation room ventilation and waste gas scavenging is performed.

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“…It has been shown, however, that rather high occupational exposure may lead to enzyme induction in humans (Duvaldestin et al 1981b) and in animals (Plummer et al 1986). Halothane is not carcinogenic, mutagenic or teratogenic under these circumstances Mazze et al 1986;Vessey & Nunn 1980).…”

Section: Pharmacokinetic Drug Interactionsmentioning

confidence: 99%

“…As for halothane there is no evidence that exposure to enflurane in ventilated theatres equipped with scavenging devices represents any health hazard to the staff Mazze & Lecley 1985;Mazze et al 1986;Plummer et al 1986;Vessey & Nunn 1980). …”

Section: Occupational Exposurementioning

confidence: 99%

Clinical Pharmacokinetics of the Inhalational Anaesthetics

Dale

Brown

1987

Clinical Pharmacokinetics

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At present, the most widely used inhalational anaesthetics are the halogenated, inflammable vapours halothane, enflurane, isoflurane and the gas nitrous oxide. The anaesthetic effect of these agents is related to their tension or partial pressure in the brain, represented at equilibrium by the alveolar concentration. The minimum alveolar concentration for a specific agent is remarkably constant between individuals. The uptake and distribution of inhalational anaesthetics depends on inhaled concentration, pulmonary ventilation, solubility in blood, cardiac output and tissue uptake. Inhalational anaesthetics are mainly eliminated by pulmonary exhalation, but significant amounts of halothane are removed by hepatic metabolism. Inhalational agents currently in use have acceptable pharmacokinetic characteristics, and clinical acceptance depends on their potential for adverse effects. Induction of anaesthesia with halothane is rapid and relatively pleasant and it is the agent of choice for paediatric anaesthesia. Between 20 and 50% is metabolised, and the parent drug is a potent inhibitor of drug metabolism. Post-operatively enzyme induction may follow. The major disadvantages of halothane are myocardial depression, propensity to evoke cardiac arrhythmias and the rare but serious halothane hepatitis. Induction and recovery from enflurane anaesthesia is rapid. Metabolism accounts for 5 to 9% of the elimination. The metabolic product inorganic fluoride may in rare cases cause renal toxicity. Enflurane is a weak inhibitor of drug metabolism at anaesthetic concentrations. Enflurane depresses circulation more than halothane by reducing both myocardial contractility and systemic vascular resistance, but cardiac rhythm is stable. Enflurane anaesthesia may, unlike the other agents, induce epileptic activity. Enflurane is widely used as replacement for halothane in adults. Despite its low blood-gas solubility, the airway irritability of isoflurane precludes a faster induction of anaesthesia than with halothane. Isoflurane is almost resistant to biodegradation. Myocardial contractility is maintained during isoflurane anaesthesia and cardiac rhythm is stable except for the occurrence of tachycardia in some patients. Isoflurane is the inhalational agent of choice for neurosurgical operations. Sevoflurane is an experimental ether vapour: induction and recovery is fast and pleasant. It is metabolised to the same extent as enflurane and subnephrotoxic concentrations of inorganic fluoride may result. Sevoflurane has fewer respiratory and cardiovascular depressant effects than halothane and may be a future alternative for paediatric anaesthesia.(ABSTRACT TRUNCATED AT 400 WORDS)

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Effects of Chronic Inhalation of Halothane, Enflurane or Isoflurane in Rats

Cited by 25 publications

References 0 publications

Down-regulation of hepatic CYP1A2 plays an important role in inflammatory responses in sepsis

Down-regulation of hepatic CYP1A2 plays an important role in inflammatory responses in sepsis

Occupational exposure to sevoflurane during cardiopulmonary bypass

Clinical Pharmacokinetics of the Inhalational Anaesthetics

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