An Open-label Comparison of a New Generic Sevoflurane Formulation With Original Sevoflurane in Patients Scheduled for Elective Surgery Under General Anesthesia

作者：Byon Hyo Jin; Choi Byung Moon; Bang Ji Yeon; Lee Eun Kyung; Lee Sang Seok; Noh Gyu Jeong^*

来源：Clinical Therapeutics, 2015, 37(4): 887-901.

DOI：10.1016/j.clinthera.2015.01.012

• compound A
• effectiveness
• generic sevoflurane
• inorganic fluoride

Purpose: To compare the stability, effectiveness, and safety profiles of a new generic sevoflurane with those of the original sevoflurane formulation in patients undergoing elective surgery.
Methods: An accelerated 3-month storage test was performed to evaluate the compositional changes in generic sevoflurane stored in glass bottles. In addition, 182 patients were randomly: allocated to receive generic (n = 89 [54 men and 35 women]; mean [SD] age, 49.9 [11.6] years) or original (n = 93 [61 men and 32 women]; mean [SD] age, 49.6 [11.1] years) sevoflurane at a gas flow of 3 L/min for approximately 3 hours. The mean minimum alveolar concentration (MAC) during sevoflurane anesthesia was evaluated, and gas samples for measuring compound A were collected from the inspiratory limb of the circuit at preset intervals. Blood samples for measuring serum inorganic fluoride were obtained at preset intervals (pharmacokinetic group: generic/original sevoflurane = 45/46). Renal biomarkers, such as N-acetyl-beta-glucosaminiclase, alpha- and pi-glutathione-S-transferase, albumin, urine protein and osmolality, serum creatinine and osmolality, creatinine clearance, and blood urea nitrogen, were measured at preset intervals (renal biomarker group: generic/original sevoflurane = 44/47). Adverse reactions were monitored for 72 hours after discontinuation of sevoflurane use.
Findings: Generic sevoflurane contained, glass bottles was stable for 3 months. The mean MAC was similar for generic and original sevoflurane (median [range], 0.93 [0.67-1.29] vs 0.94 [0.637.1.5] v61%). Adverse event rates Were similar (90.3% vs 84.3%), as were the AUC(last) of inorganic fluoride (333.7 [112.7-1264.7] vs 311.9 [81.5-1266.5] hours.mu mol/L) and compound A (51.8 [6.3-204.5] vs. 55.3 [10.8-270.6] hours.ppm). Biomarkers associated with renal injury were not significantly different between the 2 formulations.

• 出版日期2015-4