Читать книгу Manual of Equine Anesthesia and Analgesia - Группа авторов - Страница 305

 The fluorinated anesthetics sevoflurane and enflurane have not been associated with a decrease in renal function post‐operatively.

 Sevoflurane undergoes minimal biotransformation (2–5%) in the liver. Nevertheless, hepatic metabolism results in the formation of inorganic fluoride and an organic metabolite.Serum inorganic fluoride concentrations can attain values of 20–40 μmol/l after 2 MAC hours of exposure in humans, and >50 μmol/l after prolonged exposure.Values >50 μmol/l are considered to be nephrotoxic after exposure to methoxyflurane, as determined by a decrease in the kidney's concentrating abilities, with clinical signs of toxicity occurring at values >90 μmol/l.The difference in nephrotoxicity between the two anesthetic agents may be related to methoxyflurane undergoing intrarenal metabolism, whereas sevoflurane is primarily metabolized by the liver.Additionally, methoxyflurane is highly soluble in the tissues and takes many hours to be completely cleared from the body. Therefore, the area under the curve of exposure to fluoride is much larger with methoxyflurane than it is with sevoflurane.