Document Detail

Pharmacokinetics of sevoflurane uptake into the brain.
MedLine Citation:
PMID:  15549979     Owner:  NLM     Status:  MEDLINE    
Two recent studies have examined the pharmacokinetics of sevoflurane in adults. Lu et al.(Pharmacokinetics of sevoflurane uptake into the brain and body, Anaesthesia 2003; 58: 951-6) observed that jugular bulb sevoflurane concentration initially rose unexpectedly rapidly and then approached arterial concentrations unexpectedly slowly, suggesting that a blood-brain diffusion barrier exists. They also observed a large alveolar-arterial sevoflurane gradient, suggesting that an alveolar-arterial diffusion barrier exists. Nakamura et al. (Predicted sevoflurane partial pressure in the brain with an uptake and distribution model: Comparison with the measured value in internal jugular vein blood. Journal of Clinical Monitoring and Computing 1999; 15: 299-305) found no diffusion barriers. We used a computer model to analyse both data sets and show that the observations of Lu et al. can be explained by contamination of jugular samples with extracerebral blood. It is possible that the alveolar-arterial gradients observed by Lu et al. are due to discrepancies in conversions between blood concentrations and gas partial pressures. Our study suggests that there is no blood-brain diffusion barrier for sevoflurane and that the data of Lu et al. must be interpreted with caution.
M J Turner; T J McCulloch; R R Kennedy; A B Baker
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Publication Detail:
Type:  Comment; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anaesthesia     Volume:  59     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-11-19     Completed Date:  2004-12-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  1201-6     Citation Subset:  AIM; IM    
Department of Anaesthetics, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia.
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MeSH Terms
Anesthetics, Inhalation / blood,  pharmacokinetics*
Blood-Brain Barrier
Brain / metabolism*
Computer Simulation
Jugular Veins
Methyl Ethers / blood,  pharmacokinetics*
Models, Biological
Partial Pressure
Tissue Distribution
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane
Comment On:
Anaesthesia. 2003 Oct;58(10):951-6   [PMID:  12969036 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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