Figure 8-16 Serum inorganic fluoride (F^- ) concentration before and after administration of methoxyflurane, sevoflurane, enflurane, isoflurane, and desflurane anesthesia. After 2 to 3 minimum alveolar concentration (MAC)-hours of methoxyflurane, the mean peak F^- concentration was 61 ± 8 mol/L, which slowly declined. Sevoflurane anesthesia of 3.7 MAC-hours resulted in a mean peak F^- concentration of 30.6 ± 2 mol/L, which declined more rapidly than methoxyflurane but remained elevated for several days. After 2.7 MAC-hours of enflurane, the mean peak F^- concentration was 22.2 ± 2.8 mol/L, which also declined over several days. There was no increase in the F^- concentration after desflurane and almost no increase in the F^- concentration after isoflurane administration. (Adapted from Baden JM, Rice SA: Metabolism and toxicity of inhaled anesthetics. In Miller RD [ed]: Anesthesia, 5th ed. New York, Churchill Livingstone, 2000, p 147.)