Hepatic metabolic ability during anasthesia Evaluation of antipyrine half-lives and their relation to enflurane metabolism |
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| Authors: | M OIKKONEN P H ROSENBERG P J NEUVONEN |
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| Institution: | M. Oikkonen, MD, P.H. Rosenberg, MD, Department of Anasthesia, Surgical Hospital, Helsinki University Central Hospital. Kasarmikatu 11–13, Helsinki 13, Finland;P.J. Neuvonen, MD, Department of Clinical Pharmacology, University of Helsinki, Paasikivenkatu 4, Helsinki 25, Finland. |
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| Abstract: | The antipyrine (phenazone) half-life was determined in 20 surgical patients to discover whether there are changes in hepatic metabolic rate during or immediately after anaesthesia compared with the pre-anaesthetic rate. Nine patients received enflurane (mean duration 8.6, SD 2.0 hours) and six patients had a balanced anaesthetic without enflurane (duration 4.4, SD 3.3 hours). A further five patients received a spinal anaesthetic with bupivacaine. The changes in antipyrine half-life were inconsistent, and there was no evidence of competitive metabolic inhibition by general anaesthesia. Antipyrine half-lives did not correlate with serum fluoride levels or urinary fluoride excretion in the case of enflurane. The mean serum inorganic fluoride concentration rose to 29 mumol/litre, and two patients had potentially nephrotoxic concentrations (64 and 50 mumol/litre) after 8 hours of exposure to enflurane though without any evident harmful effects. |
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| Keywords: | Metabolism antipyrine Anasthetics volatile enflurane |
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