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February 16, 1970

Methoxyflurane, Tetracycline, and Renal Failure

Author Affiliations

From the Section of Anesthesiology, Guthrie Clinic Ltd., Robert Packer Hospital, Sayre, Pa. Dr. Kuzucu is now with the Department of Anesthesiology, St. Mary's Hospital, Waterbury, Conn.

JAMA. 1970;211(7):1162-1164. doi:10.1001/jama.1970.03170070032006

Among 115 patients who had abdominal or thoracic surgery after the administration of methoxyflurane anesthesia, seven received tetracycline hydrochloride immediately before or after the operation. Five of them had increasing levels of blood urea nitrogen (BUN) and serum creatinine. Three patients died, and autopsy of the kidneys showed numerous calcium oxalate crystals. The remaining 108 patients either did not receive any antibiotic or received penicillin, streptomycin sulfate, or chloramphenicol. None of them had postoperative renal failure or significant increase in BUN and creatinine levels. Forty patients received tetracycline after spinal anesthesia without evidence of renal failure postoperatively. It is likely that methoxyflurane and tetracycline, when administered concurrently, may seriously impair renal function leading to death.