Sevoflurane Elimination and Hystopathological Changes in Lung, Liver, Kidney and Brain Tissues

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TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, vol.30, no.6, pp.1787-1794, 2010 (SCI-Expanded) identifier identifier


Objective: The aim of this study was to investigate the fluoride levels in lung, liver, kidney and brain tissues, and the histopathological changes of lung, liver and kidney tissues due to sevoflurane metabolism and fluoride uptake. Material and Methods: Study was performed on 24 New Zealand white rabbits weighing 2500-3000g. After the animals were anesthetized with intramuscular 35 mg/kg ketamine ve 5 mg/kg xylasine, all rabbits were monitored with ECG, oxygen saturation, oro-pharyngeal temperature, and the ear vein was cannulated. Rabbits were randomly allocated into four groups as Group I: Control group (n= 6), (anesthesia was maintained with IV 10 mg/kg ketamine, 3 mg/kg xylasine and 100% O(2)),Group II: Sevoflurane 1 (n=6), Group III: Sevoflurane 24 (n=6) and Group IV: Sevoflurane 48 (n=6).Anesthesia was maintained with sevoflurane in oxygen at a concentration of 2% in sevoflurane groups. All rabbits were extubated after three hours of anaesthesia. Rabbits were sacrificed with high dose ketamine/xylasine at 1,24 and 48 hours postexposure in Group II, III and IV, respectively. Biopsies were obtained from kidney, liver, brain, and lung for the determination of inorganic fluoride deposition and histopathological examination was performed in kidney, liver and lung tissues. Results: While maximum fluoride deposition was observed in kidney, minimum deposition was observed in the liver at one hour after anesthesia. After 24 and 48 hours, the fluoride levels decreased in the kidneys and increased mostly in the lungs. However, this deposition did not produce histopathological damage. In the liver, the fluoride levels increased at 24 hours (p<0.05). The histopathological damages were observed in the liver and kidney at 24 hours, and continued at 48 hours. Conclusion: It is concluded that the fluoride which occurs after sevoflurane metabolism deposits in the kidney at early phase and is eliminated after 24 hours however it deposits mostly in the lung and secondly in the liver. The histopathological changes seen in the liver and kidney 24 hours after sevoflurane anesthesia were not related to fluoride deposition in these tissues.