Shiraishi Y, Ikeda K
Department of Anesthesiology, Hamamatsu University School of Medicine, Shizuoka, Japan.
J Clin Anesth. 1990 Nov-Dec;2(6):381-6. doi: 10.1016/0952-8180(90)90024-w.
To compare the volatile anesthetic sevoflurane with halothane, enflurane, and isoflurane on the uptake and biotransformation in humans.
Prospective pharmacokinetic study of sevoflurane administration in human subjects.
Inpatient surgery clinic at a university medical center.
Thirty-two Japanese patients, free of systemic diseases, undergoing minor elective surgery with endotracheal general anesthesia.
The patients were assigned randomly to one of four groups: halothane, enflurane, isoflurane, or sevoflurane. One of the four volatile anesthetics being investigated [equivalent to 1.1 minimum alveolar concentration (MAC): halothane, 0.85%; enflurane, 1.85%; isoflurane, 1.27%; and sevoflurane, 1.88%; in inspired concentrations throughout the first hour of anesthesia] was administered for 60 minutes.
In all patients, serum and urinary fluoride concentrations were measured. The concentrations of all gases were measured separately with a mass spectrometer. The cumulative uptake of each anesthetic agent during a certain period was calculated as an integration of the uptake rate per minute. The results for one-hour inhalation of sevoflurane (1.1 MAC) showed an uptake (corrected for body surface area and MAC) of 490 ml/m2/MAC and estimated degradation rate of 3.3%. For purposes of comparison, similar studies of halothane (uptake, 653 ml/m2/MAC; degradation rate 15.7%), enflurane (1150 ml/m2/MAC; 1.3%), and isoflurane (439 ml/m2/MAC; 0.6%) were also conducted. Sevoflurane had a peak serum inorganic fluoride concentration of 19.3 mumol/L, and no abnormality in hepatic or renal functions was observed in any of the subjects during the two weeks postoperatively.
Accurate determinations of uptake and degradation rate for sevoflurane and three other volatile anesthetics in Japanese patients were obtained. These findings have established that, despite its relatively large MAC (1.71%), sevoflurane has a small uptake due to its low solubility. However, the degradation rate was shown to be as high as 3.3%, resulting in a higher serum fluoride concentration than seen after administration of isoflurane, halothane, and (possibly) enflurane.
比较挥发性麻醉剂七氟醚与氟烷、恩氟烷和异氟烷在人体中的摄取和生物转化情况。
对人体受试者给予七氟醚的前瞻性药代动力学研究。
大学医学中心的住院手术诊所。
32名无全身性疾病的日本患者，接受气管内全身麻醉下的小型择期手术。
患者被随机分配到四组之一：氟烷、恩氟烷、异氟烷或七氟醚。在麻醉的第一个小时内，给予四种正在研究的挥发性麻醉剂之一（相当于1.1最低肺泡浓度[MAC]：氟烷，0.85%；恩氟烷，1.85%；异氟烷，1.27%；七氟醚，1.88%），持续60分钟。
对所有患者测量血清和尿氟浓度。用质谱仪分别测量所有气体的浓度。计算某一时期内每种麻醉剂的累积摄取量，作为每分钟摄取率的积分。七氟醚（1.1 MAC）吸入一小时的结果显示摄取量（根据体表面积和MAC校正）为490 ml/m2/MAC，估计降解率为3.3%。为作比较，还对氟烷（摄取量，653 ml/m2/MAC；降解率15.7%）、恩氟烷（1150 ml/m2/MAC；1.3%）和异氟烷（439 ml/m2/MAC；0.6%）进行了类似研究。七氟醚的血清无机氟峰值浓度为19.3 μmol/L，术后两周内任何受试者均未观察到肝肾功能异常。
获得了日本患者中七氟醚及其他三种挥发性麻醉剂摄取和降解率的准确测定结果。这些发现表明，尽管七氟醚的MAC相对较大（1.71%），但由于其溶解度低，摄取量较小。然而，其降解率高达3.3%，导致血清氟浓度高于异氟烷、氟烷和（可能）恩氟烷给药后。
