Serum inorganic fluoride levels in obese patients during and after enflurane anesthesia

J. B. Bentley; R. W. Vaughan; M. S. Miller; J. M. Calkins; A. J. Gandolfi

doi:10.1213/00000539-197909000-00013

Serum inorganic fluoride levels in obese patients during and after enflurane anesthesia

J. B. Bentley, R. W. Vaughan, M. S. Miller, J. M. Calkins, A. J. Gandolfi

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Abstract

Serum ionic fluoride levels in 24 markedly obese patients (127.6 ± 6.0 kg) and 7 nonobese control subjects (67.3 ± 1.2 kg) were compared during and following enflurane anesthesia (<2.0 MAC hr). Peak serum fluoride levels were higher (28.0 ± 1.9 vs 17.3 ± 1.3 μM/L, p < 0.01) and the rate at which fluoride levels increased was more rapid (slope 5.6 vs 2.5 μM/L/hr) in obese patients than in control patients. No clinical evidence of nephrotoxicity was found in either group. Vasopressin resistance tests were not performed, and thus it is unknown whether subclinical nephrotoxicity occurred in either study group. Possible reasons for increased enflurane metabolism in obesity are discussed. These possibilities include differences in fluoride ion kinetics, hepatic delivery and penetration of volatile anesthetics, and altered hepatic microsomal enzyme activity. Obesity rather than weight is an important determinant of anesthetic biotransformation.

Original language	English (US)
Pages (from-to)	409-412
Number of pages	4
Journal	Anesthesia and analgesia
Volume	58
Issue number	5
DOIs	https://doi.org/10.1213/00000539-197909000-00013
State	Published - 1979

ASJC Scopus subject areas

Anesthesiology and Pain Medicine

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title = "Serum inorganic fluoride levels in obese patients during and after enflurane anesthesia",

abstract = "Serum ionic fluoride levels in 24 markedly obese patients (127.6 ± 6.0 kg) and 7 nonobese control subjects (67.3 ± 1.2 kg) were compared during and following enflurane anesthesia (<2.0 MAC hr). Peak serum fluoride levels were higher (28.0 ± 1.9 vs 17.3 ± 1.3 μM/L, p < 0.01) and the rate at which fluoride levels increased was more rapid (slope 5.6 vs 2.5 μM/L/hr) in obese patients than in control patients. No clinical evidence of nephrotoxicity was found in either group. Vasopressin resistance tests were not performed, and thus it is unknown whether subclinical nephrotoxicity occurred in either study group. Possible reasons for increased enflurane metabolism in obesity are discussed. These possibilities include differences in fluoride ion kinetics, hepatic delivery and penetration of volatile anesthetics, and altered hepatic microsomal enzyme activity. Obesity rather than weight is an important determinant of anesthetic biotransformation.",

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T1 - Serum inorganic fluoride levels in obese patients during and after enflurane anesthesia

AU - Bentley, J. B.

AU - Vaughan, R. W.

AU - Miller, M. S.

AU - Calkins, J. M.

AU - Gandolfi, A. J.

PY - 1979

Y1 - 1979

N2 - Serum ionic fluoride levels in 24 markedly obese patients (127.6 ± 6.0 kg) and 7 nonobese control subjects (67.3 ± 1.2 kg) were compared during and following enflurane anesthesia (<2.0 MAC hr). Peak serum fluoride levels were higher (28.0 ± 1.9 vs 17.3 ± 1.3 μM/L, p < 0.01) and the rate at which fluoride levels increased was more rapid (slope 5.6 vs 2.5 μM/L/hr) in obese patients than in control patients. No clinical evidence of nephrotoxicity was found in either group. Vasopressin resistance tests were not performed, and thus it is unknown whether subclinical nephrotoxicity occurred in either study group. Possible reasons for increased enflurane metabolism in obesity are discussed. These possibilities include differences in fluoride ion kinetics, hepatic delivery and penetration of volatile anesthetics, and altered hepatic microsomal enzyme activity. Obesity rather than weight is an important determinant of anesthetic biotransformation.

AB - Serum ionic fluoride levels in 24 markedly obese patients (127.6 ± 6.0 kg) and 7 nonobese control subjects (67.3 ± 1.2 kg) were compared during and following enflurane anesthesia (<2.0 MAC hr). Peak serum fluoride levels were higher (28.0 ± 1.9 vs 17.3 ± 1.3 μM/L, p < 0.01) and the rate at which fluoride levels increased was more rapid (slope 5.6 vs 2.5 μM/L/hr) in obese patients than in control patients. No clinical evidence of nephrotoxicity was found in either group. Vasopressin resistance tests were not performed, and thus it is unknown whether subclinical nephrotoxicity occurred in either study group. Possible reasons for increased enflurane metabolism in obesity are discussed. These possibilities include differences in fluoride ion kinetics, hepatic delivery and penetration of volatile anesthetics, and altered hepatic microsomal enzyme activity. Obesity rather than weight is an important determinant of anesthetic biotransformation.

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Serum inorganic fluoride levels in obese patients during and after enflurane anesthesia

Abstract

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