Enflurane as an internal standard in monitoring halogenated volatile anaesthetics by headspace gas chromatography-mass spectrometry

Alterations in Oscillatory Behavior of Central Medial Thalamic Neurons Demonstrate a Key Role of CaV3.1 Isoform of T-Channels During Isoflurane-Induced Anesthesia

Although the central medial nucleus (CeM) of the thalamus is an essential part of the arousal system for sleep and anesthesia initiation, the precise mechanisms that regulate its activity are not well studied. We examined the role of CaV3.1 isoform of T-type calcium channels (T-channels) in the excitability and rhythmic activity of CeM neurons during isoflurane (ISO)-induced anesthesia by using mouse genetics and selective pharmacology. Patch-clamp recordings taken from acute brain slices revealed that CaV3.1 channels in CeM are inhibited by prototypical volatile anesthetic ISO (250 and 500 μM) and selective T-channels blocker 3,5-dichloro-N-[1-(2,2-dimethyl-tetrahydro-pyran-4-ylmethyl)-4-fluoro-piperidin-4-ylmethyl]-benzamide (TTA-P2). Both TTA-P2 and ISO attenuated tonic and burst firing modes, and hyperpolarized CeM neurons from wild type (WT) mice. These effects were greatly diminished or abolished in CaV3.1 null mice. Our ensuing in vivo local field potential (LFP) recordings from CeM indicated that the ability of TTA-P2 and anesthetic concentrations of ISO to promote δ oscillation was substantially weakened in CaV3.1 null mice. Furthermore, escalating ISO concentrations induced stronger burst-suppression LFP pattern in mutant than in WT mice. Our results demonstrate for the first time the importance of CaV3.1 channels in thalamocortical oscillations from the non-specific thalamic nuclei that underlie clinically important effects of ISO.

Halogenated Anesthetics Determination in Urine by SPME/GC/MS and Urine Levels Relationship Evaluation with Surgical Theatres Contamination

In this work, a new sensitive analytical method has been developed and evaluated for the determination of the most commonly used gaseous anesthetics, desflurane, sevoflurane, and this latter's hepatic metabolite hexafluoroisopropanol (HFIP) in the urine. In addition, an evaluation of anesthetics exposition on the urine levels of a small population of surgical operators has been performed and results are briefly discussed.

Urinary sevoflurane and hexafluoro-isopropanol as biomarkers of low-level occupational exposure to sevoflurane

OBJECTIVES

Sevoflurane is an inhalation halogenated anaesthetic widely used in day and paediatric surgery. We were interested in evaluating biological markers of exposure to sevoflurane, which should improve the health surveillance of occupationally exposed personnel.

METHODS

A group of 36 subjects (13 male, 23 female) occupationally exposed to volatile anaesthetics in paediatric operating rooms was studied in a 2-week survey. Post-shift urine samples and specimens from passive samplers (for personal monitoring) were collected after 1.75-6 h morning exposure and analysed by headspace gas chromatography-mass spectrometry (GC-MS). Multiple determinations were assumed as independent values (in total, n = 78: 24 from men, 54 from women; 25 from smokers, 53 from non-smokers).

RESULTS

Median sevoflurane external values were 0.13 parts per million (ppm) (range 0.03-18.82) (n = 78), urinary sevoflurane 0.6 microg/l urine (ND-18.5)(n = 76) and total urinary hexafluoro-isopropanol (HFIP) 0.49 mg/l urine (ND-6833.4) (n = 75). A lower limit of detection (LOD) was achieved for urinary sevoflurane (0.03 microg/l urine), allowing quantitation of all but one of the samples; >25% of urine samples were unquantifiable by HFIP and were assigned a value equal to half the LOD of 0.10 mg/l(urine). Urinary sevoflurane correlated well with breathing-zone data (r2 = 0.697 at log-log linear regression), whereas total urinary HFIP (r2 = 0.562 at log-log linear regression) seemed to be better described by a three-parameter logistic function and appeared to be influenced by smoking habits. Biological indices corresponding to National Institute for Occupational Safety and Health (NIOSH) exposure limits, calculated as means of linear regression slope and y intercept, were 3.9 mug/l(urine) and 1.4 microg/l urine for sevoflurane (corresponding to 2 ppm and 0.5 ppm, respectively), and 2.66 mg/l urine and 0.82 mg/l urine for HFIP.

CONCLUSIONS

On the basis of our data, urinary unmodified, sevoflurane seems to be a more sensitive and reliable biomarker of short-term exposure to sevoflurane with respect to total urinary metabolite HFIP, which appears to be influenced by physiological and/or genetic individual traits, and seems to provide an estimate of integrated exposure.

High-speed capillary gas chromatography for determination of inhalation anesthetics

To increase sample throughput for GC analysis of inhalation anaesthetics without affecting the separation of nitrous oxide (N2O) and halogenated anaesthetics (sevoflurane, isoflurane and halothane), we explored the effectiveness of a tailor-shortened (12 m) PlotQ capillary column and developed a high-speed version of a previously reported GC technique (involving chromatographic separation of analytes using a GC-MS system, coupled with a selected ion monitoring (SIM) method to increase sensitivity). Efficient separation and repeatable results were achieved at a reduced runtime of approximately 7 min (versus 18 min with the original method) at a carrier gas flow of 1.5 ml/min. This approach should more than double the previous throughput.

Simultaneous determination of unmodified sevoflurane and of its metabolite hexafluoroisopropanol in urine by headspace sorptive extraction–thermal desorption–capillary gas chromatography–mass spectrometry

Unmodified sevoflurane and its metabolite, hexafluoroisopropanol (HFIP), have both been proposed as biomarkers of exposure in post-shift urine for operating room personnel exposed to inhalation anaesthetic sevoflurane. We used headspace sorptive extraction (HSSE) and thermal desorption-capillary GC-MS to assess sensitively both compounds in the urine matrix (after a HFIP deconjugation step). In GC-MS splitless mode, calibration plots (approximately 15-650 microg/L) were linear (r2 > 0.9910) and the limits of detection (1 microg/L for both biomarkers) showed increased sensitivity for HFIP with respect to the previously described headspace GC-MS method. The method was suitable for biological monitoring of both biomarkers of exposure to sevoflurane.