Renal failure and interstitial nephritis due to trichloroethylene anesthesia and high-dose penicillin

An unusual case of acute renal failure is described. The patient, who had no previous history or signs of renal impairment, underwent lumbar laminectomy under general anesthesia with trichloroethylene (Trilene) and nitrous oxide. On the fifth postoperative day i.v. administration of 12 million units of penicillin was started. Within 16 h the patient developed oliguria and a clinical picture of acute renal failure. The course of the disease was prolonged and necessitated four hemadialysis treatments. The patient recovered only about 50% of his renal function. A biopsy performed two months after the onset of the acute renal failure was interpreted as indicating tubulo-interstitial nephritis. The role of trichloroethylene in the etiology of acute renal failure is discussed.