RESUMO
Blood concentrations of tetracaine and its metabolite, p-butylaminobenzoic acid, were measured after spinal anesthesia with tetracaine which had been administered to patients under going orthopedic surgery. Tetracaine, an ester anesthetic, was given to 10 patients, the dose was 8-14mg, and blood samples were collected 1, 2 and 6h after the injection of tetracaine. We used gas chromatography/mass spectrometry for purposes of analysis. Tetracaine was not detected in any blood sample, but the metabolite was detected in each sample with the mean concentrations of 126.5, 97.9 and 43.3ng/ml at 1, 2 and 6h, respectively. This data will be useful in determination of the cause of death after spinal anesthesia with tetracaine.
Assuntos
Ácido 4-Aminobenzoico/sangue , Raquianestesia , Anestésicos Locais/sangue , Anestésicos Locais/metabolismo , Tetracaína/sangue , Tetracaína/metabolismo , para-Aminobenzoatos , Ácido 4-Aminobenzoico/metabolismo , Adulto , Idoso , Raquianestesia/efeitos adversos , Raquianestesia/mortalidade , Anestésicos Locais/administração & dosagem , Anestésicos Locais/efeitos adversos , Causas de Morte , Dibucaína/administração & dosagem , Dibucaína/efeitos adversos , Dibucaína/sangue , Dibucaína/metabolismo , Medicina Legal/métodos , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Mepivacaína/administração & dosagem , Mepivacaína/efeitos adversos , Mepivacaína/sangue , Mepivacaína/metabolismo , Pessoa de Meia-Idade , Tetracaína/administração & dosagem , Tetracaína/efeitos adversosRESUMO
A simple method for analysis of five local anaesthetics in blood was developed using headspace solid-phase microextraction (HS-SPME) and gas chromatography-mass spectrometry-electron impact ionization selected ion monitoring (GC-MS-EI-SIM). Deuterated lidocaine (d10-lidocaine) was synthesized and used as a desirable internal standard (I.S.). A vial containing a blood sample, 5 M sodium hydroxide and d10-lidocaine (I.S.) was heated at 120 degrees C. The extraction fiber of the SPME system was exposed for 45 min in the headspace of the vial. The compounds adsorbed on the fiber were desorbed by exposing the fiber in the injection port of a GC-MS system. The calibration curves showed linearity in the range of 0.1-20 microg/g for lidocaine and mepivacaine, 0.5-20 microg/g for bupivacaine and 1-20 microg/g for prilocaine in blood. No interfering substances were found, and the time for analysis was 65 min for one sample. In addition, this proposed method was applied to a medico-legal case where the cause of death was suspected to be acute local anaesthetics poisoning. Mepivacaine was detected in the left and right heart blood samples of the victim at concentrations of 18.6 and 15.8 microg/g, respectively.
Assuntos
Anestésicos Locais/sangue , Anestésicos Locais/intoxicação , Bupivacaína/sangue , Dibucaína/sangue , Cromatografia Gasosa-Espectrometria de Massas/métodos , Temperatura Alta , Humanos , Lidocaína/sangue , Lidocaína/intoxicação , Mepivacaína/sangue , Mepivacaína/intoxicação , Prilocaína/sangue , Reprodutibilidade dos Testes , Fatores de TempoRESUMO
Serum cholinesterase levels were determined in 180 patients with carcinoma and in 146 normal subjects. Serum cholinesterase activity was significantly lower in patients suffering from cancer than in normal controls, though still within the normal range. The degree of depression of serum cholinesterase activity was influenced by the extent to which the malignancy had spread and by the site of the primary lesion.