RENAL DYSFUNCTION ASSOCIATED WITH METHOXYFLURANE ANESTHESIA, A RANDOMIZED, PROSPECTIVE CLINICAL EVALUATION

@article{Mazze1971RENALDA,
  title={RENAL DYSFUNCTION ASSOCIATED WITH METHOXYFLURANE ANESTHESIA, A RANDOMIZED, PROSPECTIVE CLINICAL EVALUATION},
  author={Richard I. Mazze and G L Shue and Stephen H. Jackson},
  journal={Survey of Anesthesiology},
  year={1971},
  volume={16},
  pages={149}
}
In a randomized, prospective, controlled clinical study, methoxyflurane anesthesia produced high-output renal insufficiency. A syndrome was observed, characterized by polyuria, lack of responsiveness to infusion of vasopressin injection, marked weight loss, and delayed return to preoperative renal concentrating ability. Also noted were hypernatremia, serum hyperosmolality, elevated blood urea nitrogen levels, increases in serum creatinine and serum uric acid, and a decrease in uric acid… 
3 Citations
Methoxyflurane and renal function.
TLDR
Reasons are presented to suggest that the rise in serum uric acid is related to urinary fluoride derived from the breakdown of methoxyflurane, and that the changes can be reduced to a degree which renders them clinically unimportant with the rational use of methocene flurane as a supplement in relaxant techniques.
Toxicity following methoxyflurane anaesthesia
TLDR
It would appear that the obese patient metabolizes methoxyflurane in a quantitatively if not qualitatively different fashion than the normal weight patient, perhaps because of fatty infiltration of the liver.
Renal toxicity of anesthetic agents
TLDR
In a group of 278 patients undergoing non-emergency general, vascular or gynecological surgery, 65 of the patients developed an increase of serum creatinine levels = 20% within the first six postoperative days, suggesting postoperative renal failure is more commonly caused by a combination of factors.
Renal function after methoxyflurane and halothane anesthesia.
TLDR
There was a significant correlation between the venous blood concentration of methoxyflurane at the end of the operation and the serum inorganic fluoride level on the first postoperative day, and there was a significantly elevated blood level of in organic fluoride found postoperatively in the methoxy flurane-treated patients.
The effect of methoxyflurane analgesia on renal function in burned patients: an investigation
TLDR
An investigation into evidence of renal dysfunction following methoxyflurane analgesia for burns dressings finds small increases in serum uric acid were observed in all of them, but no definite conclusions can be adduced.
Methoxyflurane revisited: tale of an anesthetic from cradle to grave.
  • R. Mazze
  • Medicine, Biology
    Anesthesiology
  • 2006
TLDR
Evidence to suggest that inorganic fluoride is the substance responsible for methoxyflurane renal dysfunction is suggested and a proposed metabolic pathway to support this hypothesis is presented.
Halothane-induced nephrotoxicity.
Acute renal failure. 1. Classification, evaluation, and clinical consequences.
Urinalysis and urine chemistries are most helpful in determining whether acute renal failure is due to a prerenal, renal, or postrenal cause. A plain film of the abdomen should be obtained, with
Methoxyflurane nephrotoxicity. A study of dose response in man.
TLDR
The use of methoxyflurane in clinical anesthesia should be restricted to situations where it offers specific advantages and where dosages less than 2.5 MAC hours can be attained.