Halothane renal effects

Mazze Rl, Sievenpiper TS, Stevenson J. Renal effects of enflurane and halothane in patients with abnormal renal function. Anesthesiology 1984 60 161-163. 

Methoxyflurane (Penthmne) is the most potent inhala-tional agent available, but its high solubility in tissues limits its use as an induction anesthetic. Its pharmacological properties are similar to those of halothane with some notable exceptions. For example, since methoxyflurane does not depress cardiovascular reflexes, its direct myocardial depressant effect is partially offset by reflex tachycardia, so arterial blood pressure is better maintained. Also, the oxidative metabolism of methoxyflurane results in the production of oxalic acid and fluoride concentrations that approach the threshold of causing renal tubular dysfunction. Concern for nephrotoxicity has greatly restricted the use of methoxyflurane. 

Deutsch S, Goldberg M, Stephen GW, Wu WH. Effects of halothane anesthesia on renal function in normal man. Anesthesiology 1966 27(6) 793-804. 

Priano LL Effect of halothane on renal hemodynamics during normovolemia and acute hemorrhagic hypovolemia. Anesthesiology 1985 63(4) 357-63. 

Blackmore WP, Erwin KW, Wiegand OF, Lipsey R. Renal and cardiovascular effects of halothane. Anesthesiology 1960 21 489-495. 

Hysing ES, Chelly JE, Doursout M-F, Merin RG. Comparative effects of halothane, enflurane, and isoflurane at equihypotensive doses on cardiac performance and coronary and renal blood flows in chronically instrumented dogs. Anesthesiology 1992 76 979-984. 

A Similar to halothane, but hepatitis unlikely. Only 2 - 5% metabolized, released from fat stores more rapidly than halothane. Wide margin of safety, few side effects other than renal toxicity. ... 

The pharmacokinetics of (+)-tubocurarine in man with and without renal failure, and anaesthetized with halothane and nitrous oxide, have been studied. Other studies with (+)-tubocurarine include investigations of its effects on neurally evoked compound electromyograms, its actions at hyperbaric pressures, the effects of circulating residue of the ED50 dose five minutes after injection on unexposed neuromuscular junctions, the uptake of (+)-tubo-curarine by liver lysosomes, the potentiation of (+)-tubocurarine neuromuscular blockade by lithium chloride in cats, effects on the heart and on ocular function, and the distribution of the alkaloid in cerebrospinal fluid after intravenous injection. The clinical pharmacology of dimethyl-(+)-tubocurarine (metocurine) has also been studied. ... 

The toxicity and metabolism of the fluorinated anaesthetics CF,-CHCIBr (Halothane), CFy-CHj-O-CHiCH, (Fluoroxene), and MeO CF,-CHCIj (Methoxyflurane) have been reviewed (P. H. Rosenberg and M. M. Airaksinen, Fluoride, 1973,6,41), and renal impairment linked with Methoxyflurane anaesthesia has been consider in a review concerning the effects of fluoride on the kidney (J. Jankauskas, Fluoride, 1974, 7, 93). Halothane and Fluoroxene anaesthesiology has been reviewed (S. H. Ngai, Handt. Exp. Pharmakol., 1972, 30, 33 L. E. Morris, ibid., p. 93). 

Leighton, K. M., Bruce, C. and Machin, R. (1976) The effects of furosemide on renal blood flow and cortical perfusion during methoxyfluo-rane and halothane anaesthesia. Canad. Anaesth. Soc. J., 23, 48. 

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