Davidkova T, Kikuchi H, Fujii K, Mukaida K, Sato N, Kawachi S, Morio M
Department of Anesthesiology, Hiroshima University School of Medicine, Japan.
Anesthesiology. 1988 Aug;69(2):218-22.
The serum and urinary concentrations of fluorinated metabolites of isoflurane after inhalation of three different concentrations of isoflurane were studied in 18 ASA physical status 1 or 2 patients, scheduled for orthopedic or otolaryngeal surgery. Isoflurane was administered for 60 min during fentanyl-nitrous oxide-oxygen, and its end-tidal concentration was maintained at 0.3, 0.6, or 1.15% (groups I, II, and III). The organic fluorine was determined by combustion and fluoride ions were analyzed by ion chromatography. The amounts were expressed in terms of fluoride ion. The concentrations of serum fluoride ion and organic fluorine increased significantly 15 min after the onset of inhalation of isoflurane. The mean peak values of fluoride ions were 3.8 +/- 1.1, 3.9 +/- 1.4, and 4.2 +/- 0.9 mumole/1 (M +/- SD) in patients in groups I, II, and III, respectively. The half-lives of fluoride ion and of organic fluorine as metabolites of isoflurane, calculated from the amounts excreted in urine, were 36 h and 41 h, respectively. The cumulative amounts of fluoride ion and organic fluorine excreted up to the 6th postoperative day were 548 +/- 230 and 785 +/- 452 mumoles in group I, 594 +/- 138 and 1,378 +/- 807 mumoles in group II, and 1,032 +/- 496 and 728 +/- 265 mumoles (M +/- SD) in group III, respectively. The urinary excreted fluoride ion increased in proportion to the dose of isoflurane and approximately 1.3 mmol was excreted per 1 MAC X hour inhalation of isoflurane. The authors concluded that isoflurane might be biotransformed to a greater extent than reported previously, although the serum fluoride ion level was found to be low.
在18例拟行骨科或耳鼻喉科手术、ASA身体状况为1或2级的患者中，研究了吸入三种不同浓度异氟烷后血清和尿液中异氟烷氟化代谢物的浓度。在芬太尼-氧化亚氮-氧气麻醉期间给予异氟烷60分钟，其呼气末浓度维持在0.3%、0.6%或1.15%（I组、II组和III组）。通过燃烧法测定有机氟，离子色谱法分析氟离子。含量以氟离子表示。吸入异氟烷15分钟后，血清氟离子和有机氟浓度显著升高。I组、II组和III组患者氟离子的平均峰值分别为3.8±1.1、3.9±1.4和4.2±0.9微摩尔/升（平均值±标准差）。根据尿液中排出量计算，异氟烷代谢物氟离子和有机氟的半衰期分别为36小时和41小时。I组术后第6天氟离子和有机氟的累积排出量分别为548±230和785±452微摩尔，II组为594±138和1378±807微摩尔，III组为1032±496和728±265微摩尔（平均值±标准差）。尿中排出的氟离子与异氟烷剂量成正比，每吸入1MAC×小时的异氟烷约排出1.3毫摩尔。作者得出结论，尽管发现血清氟离子水平较低，但异氟烷的生物转化程度可能比以前报道的更大。
