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Hepatic metabolic ability during anasthesia Evaluation of antipyrine half‐lives and their relation to enflurane metabolism

The antipyrine (phenazone) half‐life was determined in 20 surgical patients to discover whether there are changes in hepatic metabolic rate during or immediately after anasthesia compared with the pre‐anasthetic rate. Nine patients received enflurane (mean duration 8.6, SD 2.0 hours) and six patients had a balanced anasthetic without enflurane (duration 4.4, SD 3.3 hours). A further five patients received a spinal anasthetic with bupivacaine. The changes in antipyrine half‐life were inconsistent, and there was no evidence of competitive metabolic inhibition, by general anasthesia. Antipyrine half‐lives did not correlate with serum fluoride levels or urinary fluoride excretion in the case of enflurane. The mean serum inorganic fluoride concentrution rose to 29 μmol/litre, and two patients had potentially nephrotoxic concentrations (64 and 50 μmol/litre) after 8 hours of exposure to enflurane though without any evident harmful effects.