Minimal flow sevoflurane and isoflurane anaesthesia and impact on renal function

Abstract

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 L min-1. Compound A exposure was similar to other clinical studies which did not show changes in renal and hepatic function.

Sevoflurane: an ideal agent for adult day‐case anesthesia?

“…By 1998, 32 investigations in surgical patients and a further 14 in ‘special’ groups (such as renal failure, the elderly, cardiovascular disease) had all failed to detect any of the usual signs of renal toxicity (85). Subsequently, several other studies have also failed to detect renal damage after prolonged low‐flow sevoflurane anaesthesia (83, 84), low‐flow sevoflurane anaesthesia in patients with established renal failure (86, 87), minimal‐flow anaesthesia (88) and when aminoglycoside antibiotics are administered during low‐flow sevoflurane anaesthesia (89). This vast body of evidence would suggest that compound A is of little more than theoretical risk.…”

Inhalationsanästhetika

“…Bei Menschen liegen die inspiratorischen Compound A-Konzentrationen bei Sevofluran-Narkosen mit einem Frischgasstrom von 3 ± 6 l/min unter 10 ppm [6,25]. Bei einem Frischgasstrom £ 1,0 l/min werden wegen der gröûeren Rückatmung inspiratorisch durchschnittlich 20 ± 30 ppm Compound A angegeben [6,19,62], bei Minimal-Flow-Anästhesie (FGF = 0,5 l/min) wurden durchschnittlich 40 ppm gemessen [31]. Im geschlossenen System (Narkosegerät Physioflex ) wurden bei Sevofluran-Narkosen allerdings nur inspiratorische Compound A-Konzentrationen von ca.…”