Takenami Tamie, Arai Masayasu, Matsuzaki Shigeyuki, Anzai Ken, Ueno Tetsuo, Hoka Sumio
Department of Anesthesiology, Kitasato University School of Medicine, Sagamihara 228-8555.
Masui. 2002 Oct;51(10):1086-93.
The purpose of this study is to examine changes in serum and urinary inorganic fluoride (F) concentrations with their effects on renal and hepatic functions after repeated sevoflurane anesthesia with relatively short time interval. Eight patients received sevoflurane anesthesia twice within 7 days for gynecological surgery. Serum and urine F levels before induction, 0.5 and 1 hour after induction, and 0.5 hour after anesthesia were compared between first and second anesthesia. There were no significant differences in serum and urine F concentrations at the same point between first and second anesthesia. Two obese patients exhibited peak concentrations greater than 50 mumol.l-1 of F. Laboratory findings of renal function remained stable throughout 2 operations, whereas hepatic function deteriorated in the two obese patients after the first anesthesia, and resolved within 14 days after the second anesthesia. In conclusion, it is suggested that the second exposure to sevoflurane within 7 day interval does not alter the sevoflurane metabolism. However, obesity may contribute to a rise in serum inorganic fluoride after repeated sevoflurane anesthesia.
本研究旨在探讨在相对较短的时间间隔内重复使用七氟醚麻醉后，血清和尿中无机氟（F）浓度的变化及其对肾脏和肝脏功能的影响。8例患者因妇科手术在7天内接受了两次七氟醚麻醉。比较了首次和第二次麻醉诱导前、诱导后0.5小时和1小时以及麻醉后0.5小时的血清和尿氟水平。首次和第二次麻醉在相同时间点的血清和尿氟浓度无显著差异。两名肥胖患者的氟峰值浓度大于50μmol·l-1。在整个两次手术过程中，肾功能的实验室检查结果保持稳定，而两名肥胖患者在首次麻醉后肝功能恶化，并在第二次麻醉后14天内恢复。总之，提示在7天间隔内再次接触七氟醚不会改变七氟醚代谢。然而，肥胖可能导致重复使用七氟醚麻醉后血清无机氟升高。
