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October 5, 1970

Toxicity Following Methoxyflurane Anesthesia: II. Fluoride Concentrations in Nephrotoxicity

Author Affiliations

From the departments of pharmacology and toxicology (Dr. Taves), radiation biology and biophysics (Mr. Fry), medicine (Dr. Freeman), and anesthesiology (Dr. Gillies); University of Rochester School of Medicine and Dentistry, Rochester, NY.

JAMA. 1970;214(1):91-95. doi:10.1001/jama.1970.03180010033006

The concentrations of inorganic fluoride and nonvolatile organic fluoride were measured in a patient with nephrotoxic effects following methoxyflurane anesthesia. Concentrations of both were markedly elevated compared to two patients who received methoxyflurane without subsequent nephrotoxic effects. Indirect evidence suggests that the inorganic fluoride concentration was sufficient to account for the nephrotoxic effects. The prolonged elevation of inorganic fluoride observed can be explained on the basis of the breakdown of the nonvolatile organic fluoride to inorganic fluoride and the poor renal clearance of both types.