ABSTRACT

This chapter shows that Isoflurane is metabolized only to a very limited extent, much less than all the other anesthetics. The metabolism of halothane has always been considered to be oxidative and to result in the formation of trifluoroacetic acid. The metabolism of each of the volatile anesthetic agents in use is primarily from the point of view of the fluoride released rather than the significance of the other metabolites. The microsomal mixed-function oxidase system may select one of two sites on the methoxyflurane molecule for attack, a fact that makes methoxyflurane unique amongst the volatile anesthetic agents. The possibility of a specific anesthetic-induced nephrotoxicity was first suggested by W. B. Crandell et al. Since all the volatile anesthetics in use contain halogens, enzymatic dehalogenation may also take place. An examination of the structure of enflurane reveals that oxidation of any of its carbon atoms will result in release of inorganic fluoride.