関: enflurane

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a nonflammable liquid (trade name Ethrane) used as an inhalation general anesthetic (同)Ethrane

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/26 10:05:08」(JST)

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Enflurane (2-chloro-1,1,2,-trifluoroethyl-difluoromethyl ether) is a halogenated ether. Developed by Ross Terrell in 1963, it was first used clinically in 1966. It was increasingly used for inhalational anesthesia during the 1970s and 1980s^[1] but is no longer in common use.

Enflurane is a structural isomer of isoflurane. It vaporizes readily, but is a liquid at room temperature.

Physical properties

Property	Value
Boiling point at 1 atm	56.5 °C
MAC	1.68
Vapor pressure at 20 °C	22.9 kPa (172 mm Hg)
Blood:gas partition coefficient	1.9
Oil:gas partition coefficient	98

Side effects

Clinically, enflurane produces a dose-related depression of myocardial contractility with an associated decrease in myocardial oxygen consumption. Between 2% and 5% of the inhaled dose is oxidised in the liver, producing fluoride ions and difluoromethoxy-difluoroacetic acid. This is significantly higher than the metabolism of its structural isomer isoflurane.

Enflurane also lowers the threshold for seizures, and should especially not be used on people with epilepsy. It is also known to cause malignant hyperthermia.

It relaxes the uterus in pregnant women.

Enflurane and methoxyflurane have a nephrotoxic effect and cause acute renal failure, usually by its nephrotoxic metabolite.^[2]

Pharmacology

The exact mechanism of the action of general anaesthetics have not been delineated.^[3] Enflurane acts as a positive allosteric modulator of the GABA_A, glycine, and 5-HT₃ receptors,^[4]^[5] and as a negative allosteric modulator of the AMPA, kainate, and NMDA receptors,^[5]^[6]^[7] as well as of nicotinic acetylcholine receptors.^[4]

Occupational safety

In the workplace, people may be exposed to enflurane by breathing it in as a waste anaesthetic gas, swallowing it, eye contact, or skin contact. The National Institute for Occupational Safety and Health (NIOSH) has set a recommended exposure limit (REL) for exposure to waste anaesthetic gas of 2 ppm (15.1 mg/m³) over a 60 minute period. Symptoms of occupational exposure to enflurane include eye irritation, central nervous system depression, analgesia, anesthesia, convulsions, and respiratory depression.^[8]

References

^ Niedermeyer, Ernst; Silva, F. H. Lopes da (2005). Electroencephalography: Basic Principles, Clinical Applications, and Related Fields. Lippincott Williams & Wilkins. p. 1156. ISBN 978-0-7817-5126-1.
^ By G. Edward Morgan, Maged S. Mikhail, Michael J. Murray, C. Philip Larson; Clinical Anaesthesiology third edition,142.
^ http://www.scientificamerican.com/article/how-does-anesthesia-work/
^ ^a ^b Elaine K. Perry; Heather Ashton; Allan H. Young (2002). Neurochemistry of Consciousness: Neurotransmitters in Mind. John Benjamins Publishing. pp. 154–. ISBN 1-58811-124-5.
^ ^a ^b Charles J. Cote; Jerrold Lerman; Brian J. Anderson (2013). A Practice of Anesthesia for Infants and Children: Expert Consult - Online and Print. Elsevier Health Sciences. pp. 499–. ISBN 1-4377-2792-1.
^ Paul Barash; Bruce F. Cullen; Robert K. Stoelting; Michael Cahalan; Christine M. Stock; Rafael Ortega (7 February 2013). Clinical Anesthesia, 7e: Print + Ebook with Multimedia. Lippincott Williams & Wilkins. pp. 116–. ISBN 978-1-4698-3027-8.
^ Lin LH, Chen LL, Harris RA (1993). "Enflurane inhibits NMDA, AMPA, and kainate-induced currents in Xenopus oocytes expressing mouse and human brain mRNA". FASEB J. 7 (5): 479–85. PMID 7681790.
^ "CDC - NIOSH Pocket Guide to Chemical Hazards - Enflurane". www.cdc.gov. Retrieved 2015-10-01.

English Journal

Theoretical studies of the interaction between enflurane and water.

Zierkiewicz W, Michalska D, Zeegers-Huyskens T.SourceFaculty of Chemistry, Wrocław University of Technology, Wybrzeże Wyspiańskiego 27, 50-370, Wrocław, Poland, Wiktor.Zierkiewicz@pwr.wroc.pl.
Journal of molecular modeling.J Mol Model.2013 Mar;19(3):1399-405. doi: 10.1007/s00894-012-1678-7. Epub 2012 Dec 5.
Increase of the atmospheric concentration of halogenated organic compounds is partially responsible for a change of the global climate. In this work we have investigated the interaction between halogenated ether and water, which is one of the most important constituent of the atmosphere. The structu
PMID 23212236

Anesthetic molecules embedded in a lipid membrane: a computer simulation study.

Darvas M, Hoang PN, Picaud S, Sega M, Jedlovszky P.SourceInstitut UTINAM (CNRS UMR 6213), Université de Franche-Comté, 16 route de Gray, F-25030 Besançon Cedex, France.
Physical chemistry chemical physics : PCCP.Phys Chem Chem Phys.2012 Oct 5;14(37):12956-69. doi: 10.1039/c2cp41581j. Epub 2012 Aug 17.
The effect of four general anesthetic molecules, i.e., chloroform, halothane, diethyl ether and enflurane, on the properties of a fully hydrated dipalmitoylphosphatidylcholine (DPPC) membrane is studied in detail by long molecular dynamics simulations. Furthermore, to address the problem of pressure
PMID 22903224

Japanese Journal

[原著］下肢手術症例に対するPGE_1使用 : 低血圧麻酔の検討

島袋泰,平良豊,湯佐祚子,戸沢好美,奥島しょう子,富村賢志,折田均,上原憲全,徳嶺譲芳,太田敏久,伊波寛,奥田佳朗,琉球大学医学部麻酔科
琉球医学会誌 = Ryukyu Medical Journal 12(4), 361-366, 1992
… The hypotension was induced by continuous drip infusion of PGE_1 untill systolic blood pressure drops to 90-100 mmHg under ethrane/N_2O anesthesia. …
NAID 120002231001

嚥下第2期における輪状咽頭筋の弛緩と収縮に関する一考察

渡邉宏,仲秋功司,前山忠嗣,森川郁郎,進武幹,十時忠秀,原野清,谷口良雄
耳鼻と臨床 36(5Supplement5), 949-956, 1990
… その結果, enflurane (Ethrane, 大日本製薬) を使用した全身麻酔下での輪状咽頭筋の嚥下圧曲線はsuxamethonium chloride (Succin, 山之内製薬) の影響により, 陽性波が消失した. …
NAID 130004403661

Ｃｒｏｗ‐Ｆｕｋａｓｅ症候群患者の麻酔経験

嶋田均,千歳和哉,荒木洋二,川名陽子,佐藤裕信,藤田尚
日本臨床麻酔学会誌 7(3), 291-294, 1987
… Anesthesia was induced with thiopental and pancuronium bromide and maintained with N2O and ethrane. …
NAID 130003582200

「エトレン」

Enflurane
Systematic (IUPAC) name
	(RS)-2-chloro-1-(difluoromethoxy)-1,1,2-trifluoro-ethane
Clinical data
AHFS/Drugs.com	Micromedex Detailed Consumer Information
Pharmacokinetic data
Protein binding	97%
Identifiers
CAS Registry Number	13838-16-9
ATC code	N01AB04
PubChem	CID: 3226
IUPHAR/BPS	7175
DrugBank	DB00228
ChemSpider	3113
UNII	91I69L5AY5
KEGG	D00543
ChEBI	CHEBI:4792
ChEMBL	CHEMBL1257
Chemical data
Formula	C3H2ClF5O
Molecular mass	184.492 g/mol
	SMILES FC(Cl)C(F)(F)OC(F)F ;
	InChI InChI=1S/C3H2ClF5O/c4-1(5)3(8,9)10-2(6)7/h1-2H ; Key:JPGQOUSTVILISH-UHFFFAOYSA-N ;
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　　[★]

Ethrane

関: エンフルラン

ンフルラン

[NiedermeyerSilva2005-1] Niedermeyer, Ernst; Silva, F. H. Lopes da (2005). Electroencephalography: Basic Principles, Clinical Applications, and Related Fields. Lippincott Williams & Wilkins. p. 1156. ISBN 978-0-7817-5126-1.

[2] By G. Edward Morgan, Maged S. Mikhail, Michael J. Murray, C. Philip Larson; Clinical Anaesthesiology third edition,142.

[3] ttp://www.scientificamerican.com/article/how-does-anesthesia-work/

[PerryAshton2002-4] Elaine K. Perry; Heather Ashton; Allan H. Young (2002). Neurochemistry of Consciousness: Neurotransmitters in Mind. John Benjamins Publishing. pp. 154–. ISBN 1-58811-124-5.

[CoteLerman2013-5] Charles J. Cote; Jerrold Lerman; Brian J. Anderson (2013). A Practice of Anesthesia for Infants and Children: Expert Consult - Online and Print. Elsevier Health Sciences. pp. 499–. ISBN 1-4377-2792-1.

[BarashCullen2013-6] Paul Barash; Bruce F. Cullen; Robert K. Stoelting; Michael Cahalan; Christine M. Stock; Rafael Ortega (7 February 2013). Clinical Anesthesia, 7e: Print + Ebook with Multimedia. Lippincott Williams & Wilkins. pp. 116–. ISBN 978-1-4698-3027-8.

[pmid7681790-7] Lin LH, Chen LL, Harris RA (1993). "Enflurane inhibits NMDA, AMPA, and kainate-induced currents in Xenopus oocytes expressing mouse and human brain mRNA". FASEB J. 7 (5): 479–85. PMID 7681790.

[8] "CDC - NIOSH Pocket Guide to Chemical Hazards - Enflurane". www.cdc.gov. Retrieved 2015-10-01.

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