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1.
Sud Med Ekspert ; 65(5): 46-51, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36196840

RESUMO

The study objective is to review the literature on the use, pharmacological properties, toxicology, and assay methods for intravenous anesthetic propofol. The scope and forms of propofol use, its pharmacokinetics, biotransformation features, which occurs more than 90% in the liver, and side effects associated with propofol use for anesthesia, are addressed. Propofol infusion syndrome (also known as PrIS) and deaths from propofol overdose due to medical errors, abuse, suicide attempts, and homicide are reported. Propofol identification and assay methods based on high-performance liquid chromatography (HPLC), gas chromatography with mass spectrometry (GC-MS), and liquid chromatography (LC) are described. The features of the methods performance are outlined; biological materials (the study objects) are listed: mainly blood and plasma, as well as urine, bile, hair, etc. The relevance of a comprehensive forensic chemical study of propofol is indicated, though there are few forensic studies of propofol.


Assuntos
Propofol , Anestésicos Intravenosos/efeitos adversos , Anestésicos Intravenosos/análise , Cromatografia Líquida/métodos , Toxicologia Forense/métodos , Cromatografia Gasosa-Espectrometria de Massas/métodos , Humanos , Propofol/efeitos adversos , Propofol/análise
2.
Anesth Analg ; 130(4): 958-966, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31124837

RESUMO

BACKGROUND: The anesthetic side effects of propofol still occur in clinical practice because no reliable monitoring techniques are available. In this regard, continuous monitoring of propofol in breath is a promising method, yet it remains infeasible because there is large variation in the blood/exhaled gas partial pressure ratio (RBE) in humans. Further evaluations of the influences of breathing-related factors on RBE would mitigate this variation. METHODS: Correlations were analyzed between breathing-related factors (tidal volume [TV], breath frequency [BF], and minute ventilation [VM]) and RBE in 46 patients. Furthermore, a subset of 10 patients underwent pulmonary function tests (PFTs), and the parameters of the PFTs were then compared with the RBE. We employed a 1-phase exponential decay model to characterize the influence of VM on RBE. We also proposed a modified RBE (RBEM) that was not affected by the different breathing patterns of the patients. The blood concentration of propofol was predicted from breath monitoring using RBEM and RBE. RESULTS: We found a significant negative correlation (R = -0.572; P < .001) between VM and RBE (N = 46). No significant correlation was shown between PFTs and RBE in the subset (N = 10). RBEM demonstrated a standard Gaussian distribution (mean, 1.000; standard deviation [SD], 0.308). Moreover, the predicted propofol concentrations based on breath monitoring matched well with the measured blood concentrations. The 90% prediction band was limited to within ±1 µg·mL. CONCLUSIONS: The prediction of propofol concentration in blood was more accurate using RBEM than when using RBE and could provide reference information for anesthesiologists. Moreover, the present study provided a general approach for assessing the influence of relevant physiological factors and will inform noninvasive and accurate breath assessment of volatile drugs or metabolites in blood.


Assuntos
Anestésicos Intravenosos/análise , Anestésicos Intravenosos/sangue , Testes Respiratórios/métodos , Propofol/análise , Propofol/sangue , Adulto , Idoso , Ar/análise , Algoritmos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Testes de Função Respiratória , Taxa Respiratória , Volume de Ventilação Pulmonar
3.
Anesth Analg ; 129(1): e20-e22, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-29200074

RESUMO

We tested whether propofol or Intralipid inoculated with Staphylococcus epidermidis would promote bacterial growth within an intravenous (IV) injection hub, a site prone to bacterial contamination. In tubes incubated under optimal conditions, S epidermidis exhibited growth in Intralipid, but not in propofol. In contrast, within the IV hub incubated with either propofol or intralipid at room temperature, S epidermidis bacterial numbers declined with time, and virtually no contamination remained after 12 hours. These data suggest that certain IV lines are inhospitable for S epidermidis.


Assuntos
Contaminação de Medicamentos , Contaminação de Equipamentos , Fosfolipídeos/análise , Propofol/análise , Óleo de Soja/análise , Staphylococcus epidermidis/crescimento & desenvolvimento , Dispositivos de Acesso Vascular/microbiologia , Emulsões/administração & dosagem , Emulsões/análise , Injeções Intravenosas , Viabilidade Microbiana , Fosfolipídeos/administração & dosagem , Propofol/administração & dosagem , Óleo de Soja/administração & dosagem , Fatores de Tempo
4.
J Sep Sci ; 42(6): 1257-1264, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30637930

RESUMO

To date, the commonly used intravenous anesthetic propofol has been widely studied, and fundamental pharmacodynamic and pharmacokinetic characteristics of the drug are known. However, propofol has not yet been quantified in vivo in the target organ, the human brain. Here, cerebral microdialysis offers the unique opportunity to sample propofol in the living human organism. Therefore, a highly sensitive analytical method for propofol quantitation in small sample volumes of 30 µL, based on direct immersion solid-phase microextraction was developed. Preconcentration was followed by gas chromatographic separation and mass spectrometric detection of the compound. This optimized method provided a linear range between the lower limit of detection (50 ng/L) and 200 µg/L. Matrix-matched calibration was used to compensate recovery issues. A precision of 2.7% relative standard deviation between five consecutive measurements and an interday precision of 6.4% relative standard deviation could be achieved. Furthermore, the permeability of propofol through a cerebral microdialysate system was tested. In summary, the developed method to analyze cerebral microdialysate samples, allows the in vivo quantitation of propofol in the living human brain. Additionally the calculation of extracellular fluid levels is enabled since the recovery of the cerebral microdialysis regarding propofol was determined.


Assuntos
Líquido Cefalorraquidiano/química , Microdiálise , Propofol/análise , Microextração em Fase Sólida , Cromatografia Gasosa-Espectrometria de Massas/instrumentação , Humanos , Microdiálise/instrumentação , Microextração em Fase Sólida/instrumentação
5.
Anal Chem ; 90(8): 5280-5289, 2018 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-29570974

RESUMO

Online monitoring of exhaled propofol concentration is important for anesthetists to provide adequate anesthesia as propofol concentrations in plasma and breath are correlated reasonably well. Exhaled propofol could be detected by 63Ni ion mobility spectrometry in negative ion mode; however, the radioactivity of 63Ni source restricts its clinical application due to safety, environmental, and regulatory concerns. An acetone-assisted negative photoionization ion mobility spectrometer (AANP-IMS) using a side-mounted vacuum ultraviolet (VUV) lamp in the unidirectional (UD) flow mode was developed for sensitive measurement of exhaled propofol by producing a high percentage of O2-(H2O) n. An adsorption sampling and time-resolved purge introduction system was developed to eliminate the interference of residual inhaled anesthetic sevoflurane based on their different adsorptions between propofol and sevoflurane on the inwall of the fluorinated ethylene propylene (FEP) sample loop. The effects of the inner diameter and the length of the sample loop on the signal intensity of propofol and the time-resolution between propofol and sevoflurane were theoretically and experimentally investigated. A sample loop with 3 mm i.d. and 150 cm length allowed sensitive measurement of exhaled propofol with a response time of 4 s, a linear response range for propofol was achieved to be 0.2 to 14 ppbv with a limit of detection (LOD) of 60 pptv, and the quantification of propofol was not influenced by the change of the sevoflurane concentration. Finally, the performance of monitoring exhaled propofol during surgery was demonstrated on a patient undergoing laparoscopic distal pancreatectomy combined with cholecystectomy.


Assuntos
Acetona/química , Expiração , Monitorização Intraoperatória , Sistemas On-Line , Propofol/análise , Testes Respiratórios , Humanos , Espectrometria de Mobilidade Iônica , Fatores de Tempo
6.
Paediatr Anaesth ; 28(3): 275-280, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29349848

RESUMO

BACKGROUND: The combination of propofol and ketamine is commonly used for total intravenous anesthesia. These drugs can be delivered in different syringes or in the same syringe. We hypothesized that the drugs might separate and different concentrations of each drug could be found in different parts of the syringe during the procedure period when they were mixed in 1 syringe. METHODS: Twelve 60-mL polypropylene syringes were prepared by mixing propofol and ketamine as 4 groups on the basis of propofol/ketamine mixture ratios (5:1 and 6.7:1) and propofol solution concentrations. Syringes were placed upright in the vertical position into a rack and kept at room temperature (21.5-22.5°C), in daylight conditions and were not moved for 360 minutes. Samples of the mixture were taken from both the top and the bottom of the syringe. The first 1 mL of the samples was discarded, the following second 1 mL of the samples was filtered using 0.2-µm polytetrafluoroethylene filters and measured twice (n = 6). Samples were taken at the following time intervals: T0, T10, T30, T60, T90, T120, T180, T240, T300, and T360 min. Syringes were checked visually for any color change and separation lines between the drugs. RESULTS: There were no significant differences between the propofol and ketamine concentrations of the top and bottom samples in all 4 groups. In addition, there were no statistically significant changes of propofol and ketamine concentrations of samples over 360 minutes in any of the 4 groups. No visual changes were observed during 6 hours' observation. CONCLUSION: The results of our measurements demonstrated that mixtures of propofol (1% and 2%) and ketamine at 5:1 and 6.7:1 ratios could be used in terms of mixture homogeneity and stability in a polypropylene syringe during a 6-hour period at room temperature.


Assuntos
Anestesia Intravenosa/métodos , Anestésicos Combinados/análise , Anestésicos Dissociativos/análise , Anestésicos Intravenosos/análise , Ketamina/análise , Propofol/análise , Criança , Cromatografia Líquida de Alta Pressão , Estabilidade de Medicamentos , Humanos , Seringas
7.
Anesth Analg ; 125(2): 616-619, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28682949

RESUMO

BACKGROUND: In early 2015, clinicians throughout Zambia noted a range of unpredictable adverse events after the administration of propofol, including urticaria, bronchospasm, profound hypotension, and most predictably an inadequate depth of anesthesia. Suspecting that the propofol itself may have been substandard, samples were procured and sent for testing. METHODS: Three vials from 2 different batches were analyzed using gas chromatography-mass spectrometry methods at the John L. Holmes Mass Spectrometry Facility. RESULTS: Laboratory gas chromatography-mass spectrometry analysis determined that, although all vials contained propofol, its concentration differed between samples and in all cases was well below the stated quantity. Two vials from 1 batch contained only 44% ± 11% and 54% ± 12% of the stated quantity, whereas the third vial from a second batch contained only 57% ± 9%. The analysis found that there were no hexane-soluble impurities in the samples. CONCLUSIONS: None of the analyzed vials contained the stated amount of propofol; however, our analysis did not detect additional contaminants that would explain the adverse events reported by clinicians. Our results confirm the presence of substandard propofol in Zambia; however, anecdotal accounts of substandard anesthetic medicines in other countries abound and warrant further investigation to provide estimates of the prevalence and scope of this global problem.


Assuntos
Anestésicos Intravenosos/análise , Anestésicos Intravenosos/normas , Contaminação de Medicamentos , Propofol/análise , Propofol/normas , Anestesia , Anestesiologia , Espasmo Brônquico/induzido quimicamente , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Hipotensão/induzido quimicamente , Urticária/induzido quimicamente , Zâmbia
8.
Am J Forensic Med Pathol ; 37(1): 4-6, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26513757

RESUMO

Propofol has gained notoriety in recent years because of its involvement in high-profile deaths and has increasingly become a drug of misuse and abuse particularly by health care personnel with easy access to it. In addition, propofol has also been used for more nefarious purposes such as murder and suicide. These, coupled with the drug's routine use for both major and minor medical procedures, provide ample opportunities for it to be implicated as a cause of death or contributing factor. In such instances, forensic investigators may be faced with the task of not only detecting the presence of propofol on postmortem toxicology screening, but also determining if it was indeed responsible for the decedent's demise. While propofol has a high volume of distribution, it is thought to equilibrate and be eliminated rapidly and not show significant tissue accumulation. However, this article presents a case illustrating that propofol can accumulate in the tissues and may be found up to a week after administration. This capacity to accumulate implies that postmortem detection does not necessarily confirm administration near the time of death, and further investigation needs to be undertaken to determine the timeline of events in order to rule out other factors, such as recent medical interventions, before attributing the cause of death to the presence of the drug.


Assuntos
Hipnóticos e Sedativos/análise , Propofol/análise , Autopsia , Cegueira/induzido quimicamente , Humanos , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/farmacocinética , Masculino , Metanol/intoxicação , Pessoa de Meia-Idade , Hipófise/patologia , Hipófise/cirurgia , Neoplasias Hipofisárias/cirurgia , Propofol/administração & dosagem , Propofol/farmacocinética , Sela Túrcica/patologia , Solventes/intoxicação
9.
Anal Chem ; 87(3): 1773-81, 2015 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-25517186

RESUMO

A fast detection method to analyze gaseous organic compounds in complex gas mixtures was developed, using a needle trap device (NTD) in conjunction with thermal-desorption photoionization time-of-flight mass spectrometry (TD-PI-TOFMS). The mass spectrometer was coupled via a deactivated fused silica capillary to an injector of a gas chromatograph. In the hot injector, the analytes collected on the NTD were thermally desorbed and directly transferred to the PI-TOFMS ion source. The molecules are softly ionized either by single photon ionization (SPI, 118 nm) or by resonance enhanced multiphoton ionization (REMPI, 266 nm), and the molecular ion signals are detected in the TOF mass analyzer. Analyte desorption and the subsequent PI-TOFMS detection step only lasts ten seconds. The specific selectivity of REMPI (i.e., aromatic compounds) and universal ionization characteristics render PI-MS as a promising detection system. As a first demonstrative application, the alveolar phase breath gas of healthy, nonsmoking subjects was sampled on NTDs. While smaller organic compounds such as acetone, acetaldehyde, isoprene, or cysteamine can be detected in the breath gas with SPI, REMPI depicts the aromatic substances phenol and indole at 266 nm. In the breath gas of a healthy, smoking male subject, several xenobiotic substances such as benzene, toluene, styrene, and ethylbenzene can be found as well. Furthermore, the NTD-REMPI-TOFMS setup was tested for breath gas taken from a mechanically ventilated pig under continuous intravenous propofol (2,6-diisopropylphenol, narcotic drug) infusion.


Assuntos
Testes Respiratórios/métodos , Espectrometria de Massas/métodos , Compostos Orgânicos/análise , Fótons , Propofol/análise , Xenobióticos/análise , Animais , Cromatografia Gasosa/métodos , Voluntários Saudáveis , Humanos , Hipnóticos e Sedativos/análise , Masculino , Pessoa de Meia-Idade , Agulhas , Suínos
10.
Br J Anaesth ; 113(5): 807-14, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25012583

RESUMO

BACKGROUND: Although pilot studies have reported that exhaled propofol concentrations can reflect intraoperative plasma propofol concentrations in an individual, the blood/exhaled partial pressure ratio RBE varies between patients, and the relevant factors have not yet been clearly addressed. No efficient method has been reported for the quick evaluation of RBE and its association with inter-individual variables. METHODS: We proposed a novel method that uses a surface acoustic wave (SAW) sensor combined with a fast gas chromatograph (GC) to simultaneously detect propofol concentrations in blood and exhaled gas in 28 patients who were receiving propofol i.v. A two-compartment pharmacokinetic (PK) model was established to simulate propofol concentrations in exhaled gas and blood after a bolus injection. Simulated propofol concentrations for exhaled gas and blood were used in a linear regression model to evaluate RBE. RESULTS: The fast GC-SAW system showed reliability and efficiency for simultaneous quantitative determination of propofol in blood (correlation coefficient R(2)=0.994, P<0.01) and exhaled gas (R(2)=0.991, P<0.01). The evaluation of RBE takes <50 min for a patient. The distribution of RBE in 28 patients showed inter-individual differences in RBE (median 1.27; inter-quartile range 1.07-1.59). CONCLUSIONS: Fast GC-SAW, which analyses samples in seconds, can perform both rapid monitoring of exhaled propofol concentrations and fast analysis of blood propofol concentrations. The proposed method allows early determination of the coefficient RBE in individuals. Further studies are required to quantify the distribution of RBE in a larger cohort and assess the effect of other potential factors. CLINICAL TRIAL REGISTRATION: ChiCTR-ONC-13003291.


Assuntos
Anestésicos Intravenosos/análise , Anestésicos Intravenosos/farmacocinética , Cromatografia Gasosa/métodos , Propofol/análise , Propofol/farmacocinética , Adulto , Idoso , Algoritmos , Anestésicos Intravenosos/sangue , Testes Respiratórios , Calibragem , Cromatografia Gasosa/instrumentação , Feminino , Gases/análise , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória/métodos , Propofol/sangue , Reprodutibilidade dos Testes
11.
J Breath Res ; 18(2)2024 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-38211315

RESUMO

The correlation between propofol concentration in exhaled breath (CE) and plasma (CP) has been well-established, but its applicability for estimating the concentration in brain tissues (CB) remains unknown. Given the impracticality of directly sampling human brain tissues, rats are commonly used as a pharmacokinetic model due to their similar drug-metabolizing processes to humans. In this study, we measuredCE,CP, andCBin mechanically ventilated rats injected with propofol. Exhaled breath samples from the rats were collected every 20 s and analyzed using our team's developed vacuum ultraviolet time-of-flight mass spectrometry. Additionally, femoral artery blood samples and brain tissue samples at different time points were collected and measured using high-performance liquid chromatography mass spectrometry. The results demonstrated that propofol concentration in exhaled breath exhibited stronger correlations with that in brain tissues compared to plasma levels, suggesting its potential suitability for reflecting anesthetic action sites' concentrations and anesthesia titration. Our study provides valuable animal data supporting future clinical applications.


Assuntos
Propofol , Humanos , Animais , Ratos , Propofol/análise , Propofol/farmacocinética , Testes Respiratórios/métodos , Expiração
12.
Anal Bioanal Chem ; 405(21): 6807-14, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23771527

RESUMO

The inappropriate or illegal use of propofol has recently come to the fore as a serious social issue in South Korea. Thus, in spite of its superior potency as a therapeutic drug, propofol was classified as a controlled drug under the purview of Narcotics Control Law in South Korea in February of 2011. Accordingly, the determination of propofol and/or its metabolites in biological specimens is required to prove ingestion. Therefore, to demonstrate chronic ingestion, a quantitative analytical method for propofol-glucuronide in hair was developed and validated using liquid chromatography-tandem mass spectrometry (LC-MS/MS). This method was applied to measure propofol-glucuronide in hair samples from 23 propofol abuse suspects and in both pigmented and nonpigmented hair from rats which had ingested propofol. Propofol-glucuronide in hair was extracted in methanol and then filtered and analyzed by LC-MS/MS with electrospray ionization in negative mode. The validation results of selectivity, matrix effect, recovery, linearity, precision and accuracy, and processed sample stability were satisfactory. The limit of detection was 20 pg/10 mg hair and the limit of quantification was 50 pg/10 mg hair. The concentration range of propofol-glucuronide in hair segments from 23 propofol abuse suspects was shown up to 1,410 pg/mg. The animal study demonstrated that the presence of melanin did not affect the deposition of propofol-glucuronide in hair. Thus, we propose propofol-glucuronide in hair as a marker for propofol abuse. This method will be very useful for monitoring the inappropriate use of propofol for both legal and public health aspects.


Assuntos
Cromatografia Líquida/métodos , Glucuronídeos/análise , Cabelo/química , Propofol/administração & dosagem , Detecção do Abuso de Substâncias/métodos , Espectrometria de Massas em Tandem/métodos , Administração Oral , Animais , Bioensaio/métodos , Masculino , Propofol/análise , Ratos , Ratos Zucker , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
13.
J Sep Sci ; 36(12): 1959-66, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23936914

RESUMO

A variety of related impurities, including starting materials, process impurities, and degradation products, can be detected in propofol. In this article, a sensitive and selective GC-MS/MS method using pulsed splitless injection technique for the determination of 11 main related impurities in propofol in one chromatogram is investigated. This method is extensively validated for its linearity, recovery, precision, LOD, and LOQ, and is able to detect trace-level related impurities (LOD = 0.2-5.6 µg/g) in propofol bulk drug. Stressed tests proposed that oxidative degradation, photolytic degradation, and heat are the main causes for the formation of degradation products in propofol.


Assuntos
Cromatografia Gasosa-Espectrometria de Massas/métodos , Propofol/análise , Espectrometria de Massas em Tandem/métodos , Contaminação de Medicamentos , Espectrometria de Massas em Tandem/instrumentação
14.
J Clin Monit Comput ; 27(5): 509-16, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23525901

RESUMO

Real-time measurement of propofol in the breath may be used for routine clinical monitoring. However, this requires unequivocal identification of the expiratory phase of the respiratory propofol signal as only expiratory propofol reflects propofol blood concentrations. Determination of CO2 breath concentrations is the current gold standard for the identification of expiratory gas but usually requires additional equipment. Human breath also contains isoprene, a volatile organic compound with low inspiratory breath concentration and an expiratory concentration plateau. We investigated whether breath isoprene could be used similarly to CO2 to identify the expiratory fraction of the propofol breath signal. We investigated real-time breath data obtained from 40 study subjects during routine anesthesia. Propofol, isoprene, and CO2 breath concentrations were determined by a combined ion molecule reaction/electron impact mass spectrometry system. The expiratory propofol signal was identified according to breath CO2 and isoprene concentrations and presented as median of intervals of 30 s duration. Bland-Altman analysis was applied to detect differences (bias) in the expiratory propofol signal extracted by the two identification methods. We investigated propofol signals in a total of 3,590 observation intervals of 30 s duration in the 40 study subjects. In 51.4 % of the intervals (1,844/3,590) both methods extracted the same results for expiratory propofol signal. Overall bias between the two data extraction methods was -0.12 ppb. The lower and the upper limits of the 95 % CI were -0.69 and 0.45 ppb. Determination of isoprene breath concentrations allows the identification of the expiratory propofol signal during real-time breath monitoring.


Assuntos
Algoritmos , Testes Respiratórios/métodos , Butadienos/análise , Monitoramento de Medicamentos/métodos , Expiração , Hemiterpenos/análise , Pentanos/análise , Propofol/administração & dosagem , Propofol/análise , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/análise , Sistemas Computacionais , Diagnóstico por Computador/métodos , Humanos , Injeções Intravenosas , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
15.
Anal Methods ; 15(33): 4179-4186, 2023 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-37578256

RESUMO

Ciprofol (HSK 3486, C14H20O), a novel 2,6-disubstituted phenol derivative similar to propofol, is a new type of intravenous general anaesthetic. We found that the exhaled ciprofol concentration could be measured online by ultraviolet time-of-flight mass spectrometry (UV-TOFMS), which could be used to predict the plasma concentration and anaesthetic effects of ciprofol. In this study, we present the calibration method and validation results of UV-TOFMS for the quantification of ciprofol gas. Using a self-developed gas generator to prepare different concentrations of ciprofol calibration gas, we found a linear correlation between the concentration and intensity of ciprofol from 0 parts per trillion by level (pptv) to 485.85 pptv (R2 = 0.9987). The limit of quantification was 48.59 pptv and the limit of detection was 7.83 pptv. The imprecision was 12.44% at 97.17 pptv and was 8.96% at 485.85 pptv. The carry-over duration was 120 seconds. In addition, we performed a continuous infusion of ciprofol in beagles, measured the exhaled concentration of ciprofol by UV-TOFMS, determined the plasma concentration by high-performance liquid chromatography, and monitored the anaesthetic effects as reflected by the bispectral index value. The results showed that the exhaled and plasma concentrations of ciprofol were linearly correlated. The exhaled ciprofol concentration correlated well with the anaesthetic effect. The study showed that we could use UV-TOFMS to provide a continuous measurement of gaseous ciprofol concentration at 20 second intervals.


Assuntos
Testes Respiratórios , Propofol , Animais , Cães , Calibragem , Testes Respiratórios/métodos , Espectrometria de Massas , Propofol/análise , Anestésicos Intravenosos , Gases
16.
Anal Chem ; 84(18): 7670-6, 2012 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-22900668

RESUMO

Propofol is a widely used, potent intravenous anesthetic for ambulatory anesthesia and long-term sedation. The target steady state concentration of propofol in blood is 0.25-10 µg/mL (1-60 µM). Although propofol can be oxidized electrochemically, monitoring its concentration in biological matrixes is very challenging due to (i) low therapeutic concentration, (ii) high concentrations of easily oxidizable interfering compounds in the sample, and (iii) fouling of the working electrode. In this work we report the performance characteristics of an organic film coated glassy carbon (GC) electrode for continuous monitoring of propofol. The organic film (a plasticized PVC membrane) improved the detection limit and the selectivity of the voltammetric sensor due to the large difference in hydrophobicity between the analyte (propofol) and interfering compounds of the sample, e.g., ascorbic acid (AA) or p-acetamidophenol (APAP). Furthermore, the membrane coating prevented electrode fouling and served as a protective barrier against electrode passivation by proteins. Studies revealed that sensitivity and selectivity of the voltammetric method is greatly influenced by the composition of the PVC membrane. The detection limit of the membrane-coated sensor for propofol in PBS is reported as 0.03 ± 0.01 µM. In serum-like electrolyte solutions containing physiologically relevant levels of albumin (5%) and 3 mM AA and 1 mM APAP as interfering agents, the detection limit was 0.5 ± 0.4 µM. Both values are below the target concentrations used clinically during anesthesia or sedation.


Assuntos
Anestésicos Intravenosos/análise , Técnicas Eletroquímicas , Eletrólitos/química , Propofol/análise , Acetaminofen/química , Ácido Ascórbico/química , Eletrodos , Membranas Artificiais , Oxirredução , Propofol/sangue
17.
Anesth Analg ; 114(5): 1086-90, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22492186

RESUMO

BACKGROUND: Anesthesiologists must consider the entire life cycle of drugs in order to include environmental impacts into clinical decisions. In the present study we used life cycle assessment to examine the climate change impacts of 5 anesthetic drugs: sevoflurane, desflurane, isoflurane, nitrous oxide, and propofol. METHODS: A full cradle-to-grave approach was used, encompassing resource extraction, drug manufacturing, transport to health care facilities, drug delivery to the patient, and disposal or emission to the environment. At each stage of the life cycle, energy, material inputs, and emissions were considered, as well as use-specific impacts of each drug. The 4 inhalation anesthetics are greenhouse gases (GHGs), and so life cycle GHG emissions include waste anesthetic gases vented to the atmosphere and emissions (largely carbon dioxide) that arise from other life cycle stages. RESULTS: Desflurane accounts for the largest life cycle GHG impact among the anesthetic drugs considered here: 15 times that of isoflurane and 20 times that of sevoflurane on a per MAC-hour basis when administered in an O(2)/air admixture. GHG emissions increase significantly for all drugs when administered in an N(2)O/O(2) admixture. For all of the inhalation anesthetics, GHG impacts are dominated by uncontrolled emissions of waste anesthetic gases. GHG impacts of propofol are comparatively quite small, nearly 4 orders of magnitude lower than those of desflurane or nitrous oxide. Unlike the inhaled drugs, the GHG impacts of propofol primarily stem from the electricity required for the syringe pump and not from drug production or direct release to the environment. DISCUSSION: Our results reiterate previous published data on the GHG effects of these inhaled drugs, while providing a life cycle context. There are several practical environmental impact mitigation strategies. Desflurane and nitrous oxide should be restricted to cases where they may reduce morbidity and mortality over alternative drugs. Clinicians should avoid unnecessarily high fresh gas flow rates for all inhaled drugs. There are waste anesthetic gas capturing systems, and even in advance of reprocessed gas applications, strong consideration should be given to their use. From our results it appears likely that techniques other than inhalation anesthetics, such as total i.v. anesthesia, neuraxial, or peripheral nerve blocks, would be least harmful to the environment.


Assuntos
Poluição do Ar/efeitos adversos , Anestésicos Inalatórios/química , Efeito Estufa , Poluição do Ar/análise , Poluição do Ar/prevenção & controle , Anestésicos Inalatórios/análise , Anestésicos Intravenosos/análise , Anestésicos Intravenosos/síntese química , Desflurano , Indústria Farmacêutica , Meia-Vida , Isoflurano/análogos & derivados , Isoflurano/análise , Isoflurano/química , Éteres Metílicos/análise , Éteres Metílicos/química , Modelos Estatísticos , Óxido Nitroso/análise , Óxido Nitroso/química , Propofol/análise , Propofol/química , Sevoflurano
18.
J Forensic Sci ; 67(6): 2479-2486, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35982590

RESUMO

Etomidate, with efficacy similar to that of propofol, has been used as a propofol substitute because propofol is a designated narcotic drug, and an increase in the frequency of illegal distribution and misuse has been reported in Korea. Previous analytical studies on etomidate used blood and urine. For long-term use and timing estimation, a method for etomidate analysis using hair should be developed. Therefore, in this study, an analytical method using LC-MS/MS was developed to determine etomidate and its major metabolite in hair. Human hair samples were segmented after washing to eliminate possible contaminants on the hair and stirred with methanol. The LC-MS/MS conditions were optimized, and the chromatographic separation time was 10 min. Selectivity, linearity, limit of detection, limit of quantification, precision, accuracy, recovery, process efficiency, matrix effect, and stability were evaluated to validate the analytical method. The calibration curves ranged from 0.25 to 50 pg/mg for etomidate and 2-250 pg/mg for etomidate acid; the coefficients of determination were higher than 0.997. The intra- and inter-assay precision results for all the compounds were <15% and satisfied at recovery, process efficiency, matrix effect, and stability. In addition, this method was applied to the hair of 4 rats which are administered with etomidate to evaluate. The etomidate concentrations in the rat hair ranged from 2.60 to 8.50 pg/mg, and the etomidate acid concentrations were 2.06-7.13 pg/mg. Thus, this method can be used as basic data for monitoring etomidate in hair.


Assuntos
Etomidato , Propofol , Humanos , Ratos , Animais , Cromatografia Líquida/métodos , Espectrometria de Massas em Tandem/métodos , Propofol/análise , Propofol/química , Cabelo/química , Detecção do Abuso de Substâncias/métodos
19.
Crit Rev Anal Chem ; 52(7): 1694-1701, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33870775

RESUMO

Propofol (PFL) owing to its excellent inhibitory property of neurotransmitters in CNS by positive modulation of ligand gated ion channels to an integrated chloride channeled GABAA thereby acts as a general anesthetic. It differs from other general anesthetics chemically and pharmacologically as it has lesser side effects compared to other general anesthetics and is most commonly used. The present review focuses on two aspects (a) various analytical methods used in quantification of Propofol in pharmaceutical formulations and (b) various analytical methods used to determine Propofol in biological matrices and some biological markers like hair and end tidal nasal air for forensic purpose to estimate drug concentration in suspected cases. Here the various analytical methods are developed using different parameters and validation of employed methods are discussed. Estimated parameters like the linearity, LOQ (Limit of quantification), % recovery, slope, intercept, validation are discussed for the individual method. The critical quality attributes like the wavelength of detection, columns, flow rate, gas flow, and the sample preparation methods for the determination of PFL by bioanalytical methods are also discussed. Type of electrode, mechanism involved and the potential voltage applied for a particular electrochemical method are also discussed.


Assuntos
Anestésicos Gerais , Canais Iônicos de Abertura Ativada por Ligante , Propofol , Anestésicos Gerais/análise , Biomarcadores/análise , Cloretos/análise , Composição de Medicamentos , Cabelo/química , Propofol/análise , Propofol/química , Propofol/farmacologia , Ácido gama-Aminobutírico/análise
20.
Anal Chem ; 83(10): 3963-7, 2011 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-21526760

RESUMO

The anesthetic agent propofol (2,6-diisopropylphenol) is the most widely used intravenously administered drug in general anesthesia. However, a viable online capability to monitor metabolized levels of propofol in patients does not currently exist. Here we show for the first time that optical spectroscopy has good potential to detect metabolized propofol from patients' exhaled breath. We present quantitative absorption measurements of gas phase propofol both in the ultraviolet and middle-infrared spectral regions. We demonstrate that a detection limit in the subparts-per-billion concentration range can be reached with photoacoustic spectroscopy in the UV spectral region, paving the way for the development of future optical monitors.


Assuntos
Anestésicos/análise , Gases/química , Propofol/análise , Espectrofotometria Ultravioleta/métodos , Anestésicos/metabolismo , Testes Respiratórios/métodos , Humanos , Propofol/metabolismo
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