Which of the following inhalational agent is contraindicated in renal disease -
Ans. is 'c' i.e., Methoxyflurane Inhalational agents and renal diseaseo Methoxyflurane is contraindicated. Enflurane and sevoflurane should also be avoided.o Desflurane is the inhalational agent of choice. Isoflurane is an alternative. Halothane is also safe.o Anaesthesia is maintained with desflurane (or isoflurane) in N2O : O2 mixture.Methoxyfluraneo It was most potent inhalation agent (least MAC), but not used not (now Halothane is most potent).o It should not be used in closed circuit (reacts with rubber tubing of the closed circuit).o It has slowest onset & recovery (however now ether has slowest onset & recovery as methoxyflurane is not used).o Boiling point is more than water (104degC).o Intrarenal metabolism of methoxyflurane and subsequent intrarenal production of fluoride ion is the significant cause of methoxyflurane renal toxicity.o It can cause high output renal failure and hepatotoxicity.
Desflurane
Isoflurane
Methoxyflurane
Halothane
Anesthesia for Kidney Disease