Document Detail


Clinical characteristics and biotransformation of sevoflurane in paediatric patients during antiepileptic drug therapy.
MedLine Citation:
PMID:  8880818     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with epilepsy on long term antiepileptic drug (AED) therapy deserve special consideration not only concerning seizure control but also the effect on anaesthetic metabolism and hepatorenal functions. In the present study, we examined the effects of sevoflurane anaesthesia on plasma inorganic fluoride (F-) level and hepatorenal function in patients with and without AED therapy. Twenty-two patients (12 with AEDs = AED group, and ten without AEDs = control group = C group), ASA I, who were free of hepatorenal disease, received approximately 2-3 h sevoflurane anaesthesia. Plasma F- analysis was performed at the stages of: 1) induction of anaesthesia, 2) conclusion of anaesthesia, 3) 15 h after the conclusion of anaesthesia, using an ion-selective electrode calibrated with a standard solution of sodium fluoride. Pre- and postoperative hepatic (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin) and renal (blood urea nitrogen, creatinine) function was tested. There were no significant differences between the two groups in the average age (AED group = 9.4 and control group = 10.1 y.o.), body weight, duration of anesthesia, and MAC hours (2.6 and 2.4). The mean peak F- levels were 15.5 and 13.6 microM, in AED and C groups (not significant), respectively. No patient exhibited F- values greater than 50 microM, the hypothetical nephrotoxic threshold. The patients showed no abnormal values either in hepatic or renal function tests postoperatively. These results suggest approximately 2-3 h sevoflurane anaesthesia to be safe in patients taking AEDs.
Authors:
H Komatsu; M Ueki; J Morita; K Chujo; K Ogli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  6     ISSN:  1155-5645     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  1996  
Date Detail:
Created Date:  1997-01-23     Completed Date:  1997-01-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  379-82     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, National Kagawa Children's Hospital, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Alanine Transaminase / blood
Alkaline Phosphatase / blood
Anesthetics, Inhalation / pharmacokinetics*,  pharmacology
Anticonvulsants / pharmacology,  therapeutic use*
Aspartate Aminotransferases / blood
Biotransformation
Child
Child, Preschool
Ethers / pharmacokinetics*,  pharmacology
Fluorides / blood
Humans
Liver / drug effects,  physiopathology
Liver Function Tests
Methyl Ethers*
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Anticonvulsants; 0/Ethers; 0/Fluorides; 0/Methyl Ethers; 28523-86-6/sevoflurane; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase; EC 3.1.3.1/Alkaline Phosphatase

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