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To the Editor.—
Another study of methoxyflurane and renal function has recently appeared (218:841, 1971). The findings indicate temporary renal dysfunction in patients receiving methoxyflurane. It is of note that the duration of anesthesia was 187 ± 42 minutes and that the inhalation anesthetic was administered with the "vaporizer setting usually less than 0.8%." To achieve tolerance of the endotrachael tube by means of methoxyflurane, nitrous oxide, and oxygen, for this length of time, the total dose of methoxyflurane administered would be excessive. While one accepts the fact that temporary renal dysfunction may occasionally follow administration of methoxyflurane, and that this temporary dysfunction may progress to a more severe impairment under certain circumstances, it seems that this is clearly a dose-related phenomenon. It would be irresponsible to claim that anesthetic agents are in themselves beneficial to the human organism; they have all been implicated in one or another postanesthetic
Viljoen JF. Methoxyflurane and Renal Function. JAMA. 1972;219(1):86. doi:10.1001/jama.1972.03190270056018
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