Among inhalational anaesthetic agents, which one releases the greatest amount of inorganic fluoride during its metabolism, the property responsible for its withdrawal from clinical use?

• A Sevoflurane
• B Enflurane
• C Isoflurane
• D Methoxyflurane ✓

Explanation

Methoxyflurane undergoes extensive hepatic defluorination, producing serum inorganic fluoride concentrations far above the threshold associated with vasopressin-resistant high-output renal failure, which led to its abandonment. Sevoflurane releases moderate fluoride levels but without significant renal injury because of differences in renal handling and intrarenal degradation. Enflurane defluorinates less than sevoflurane, and isoflurane is metabolised minimally, so option A is the strongest distractor but still far below methoxyflurane.

Reference: Miller's Anesthesia, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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