Effects of Mannitol and Furosemide on Urinary Fluoride Excretion of Surgical Patients Anaesthetized with Enflurane or Halothane

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Abstract
Urinary excretion of fluoride after enflurane anaesthesia has been found to correlate Mith urinary pH, while the correlation with urinary volume has remained unsettled. We therefore studied the ellert of moderate dobes of mannitol and furosemide on serum fluoride levels and urinary excretion of fluoride in aurgical patients alter controlled doses of enflurane (6+6+6 patients) or halothane (5+5+5 patients). The highest serum fluoride level was 31 μmol/l in an enflurane patient (enflurane dose 1.26 end‐tidal vol.%×h) and 8 μmol/l in a halothane patient (halothane dose 0.59 end‐tidal vol.%×h). Mannitol caused the greatest mean exmetion of fluoride not significant (n.s.)) in the enflurane patients without any marked rise in urinary pH or volume. Furosemide increased urinary output markedly but did not enhance urinary fluoride excretion or raise urinary pH. Compared with the control groups of both inhalation anaesthetic patients, the diuretics appeared to have no effect on the serum fluoride levels. In the enflurane patients there was a positive correlation between the change in fluoride clearance and the change in urinary pH, but not with the change in urinary volume during the first postoperative hours. On the other hand, in the halothane patients there was a positive correlation between the change in fluoride clearance and the change in urinary volume. A possible “fluoro‐uretic” action of mannitol was also seen in the halothane patients, as in the later postoperative period fluoride excretion was greatest when mannitol had been given.

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