Cimetidine and ranitidine do not affect enflurane metabolism in surgical patients

Hepatic cytochrome-P-450-linked microsomal metabolism is inhibited by cimetidine, and to a lesser extent by ranitidine. Such an inhibition might protect against the metabolite-related toxicity of inhalation anesthetics. However, in comparison with the values measured in a control group, neither cimetidine (600 mg p.o. + 200 mg i.m.) nor ranitidine (150 mg p.o. + 50 mg i.m.), both administered 11-12 h before anesthesia, inhibited enflurane metabolism as assessed by the increase in plasma inorganic fluoride concentration and urinary fluoride excretion in 21 ASA I patients anesthetized with enflurane (end-tidal concentration 0.5 +/- 0.05% for 2-6 h). The inorganic fluoride concentration in the gastric juice remained low in all groups.