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Volatile anesthetics, while increasingly utilized in intensive care medicine, are associated with significant renal adverse effects. A critical safety concern-particularly with sevoflurane-involves its potential impact on renal function. Pathophysiologically, inorganic fluoride levels exceeding 50 µmol/L are recognized as a threshold for nephrogenic diabetes insipidus, a condition generally considered reversible. Additionally, the sevoflurane degradation product "compound A" has been implicated in direct renal tubular and glomerular toxicity. Specifically, exposure has been correlated with glomerular damage, evidenced by albuminuria, as well as injury to both proximal and distal tubules, indicated by elevated levels of α-glutathione-S-transferase. Postprandial glycosuria may also be observed. Unlike nephrogenic diabetes insipidus, the structural damage induced by compound A may result in irreversible renal impairment.
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http://dx.doi.org/10.3390/toxics13060514 | DOI Listing |
Br J Anaesth
September 2025
Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven, Belgium.
BMJ Open
September 2025
Department of Anaesthesiology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, Netherlands
Introduction: Ischaemia reperfusion injury (IRI) is inevitable in kidney transplantation and negatively affects patient and graft outcomes. Anaesthetic conditioning (AC) refers to the use of anaesthetic agents to mitigate IRI. AC is particularly associated with volatile anaesthetic (VA) agents and to a lesser extent to intravenous agents like propofol.
View Article and Find Full Text PDFCureus
August 2025
Department of Anesthesiology, Perioperative Medicine, and Pain Management, Jackson Memorial Hospital, Miami, USA.
May-Thurner syndrome (MTS) is characterized by the compression of the left common iliac vein by the overlying right common iliac artery, which can lead to venous insufficiency, obstruction, and an increased risk of iliofemoral deep vein thrombosis (DVT) and pulmonary embolism (PE). We report the perioperative anesthetic management of a 38-year-old female with symptomatic MTS who underwent a total laparoscopic hysterectomy, bilateral salpingectomy, and lysis of adhesions for abnormal uterine bleeding. The patient had a history of persistent left lower extremity symptoms despite prior left common iliac vein stenting and was on chronic anticoagulation therapy with rivaroxaban.
View Article and Find Full Text PDFCardiol Young
September 2025
Department of Pediatrics, Division of Pediatric Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
Objectives: Describe the hemodynamic implications of anaesthetic choice among children with heart disease undergoing cardiac catheterisation.
Methods: Study 1 was a secondary analysis of data obtained during catheterisation-based hemodynamic assessment of infants with hypoplastic left heart syndrome following Stage 1 palliation, randomised in the Single Ventricle Reconstruction trial. Measured and calculated hemodynamics including pulmonary and systemic vascular resistance indexed to body surface area (PVRi and SVRi respectively) and pulmonary/systemic blood flow (Qp/Qs) were analysed with respect to anaesthetic employed during catheterisation, classified as moderate sedation or general anaesthesia.
Indian J Anaesth
September 2025
Department of Anaesthesia, Affiliated Hospital of Xuzhou Medical University, China.
Background And Aims: As gynaecological laparoscopic minimally invasive surgery continues to advance, it becomes essential to explore how inhalation anaesthesia and intravenous anaesthesia affect the recovery of gastrointestinal function after surgery. The objective was to compare the effects of total intravenous anaesthesia (TIVA) and inhalation anaesthesia on the time of the first defecation and the time of consuming solid food for patients following laparoscopic total hysterectomy.
Methods: This research involved 134 female participants aged 18-65 years, classified as American Society of Anesthesiologists physical status I-II, who were scheduled to undergo elective laparoscopic hysterectomy procedures.