| 基于UPLC-MS/MS技术监测老年患者术后血浆中苯磺酸顺阿曲库铵残留 |
| 投稿时间：2022-06-07 修订日期：2022-10-12 点此下载全文 |
| 引用本文：徐佳明,周晓芳,郭建荣.基于UPLC-MS/MS技术监测老年患者术后血浆中苯磺酸顺阿曲库铵残留[J].药学实践杂志,2023,41(3):192~196 |
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| 基金项目:上海市浦东新区卫生健康委员会卫生科技项目（PW2020A-17） |
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| 中文摘要:目的 建立超高效液相色谱-串联质谱法（UPLC-MS/MS）测定人血浆中苯磺酸顺阿曲库铵的含量，并应用于临床治疗中监测老年患者手术后血浆中的药物残留。方法 样品经含0.1%甲酸的乙腈溶液蛋白沉淀处理后，采用SHISEIDO（资生堂）ADME（3.0 mm×100 mm，2.7 μm）色谱柱，流动相以含0.1%甲酸的2 mmol/L乙酸铵溶液和乙腈溶液（30:70，V/V），等度洗脱。质谱检测选择AJS-ESI离子源正离子模式，多反应监测（MRM）检测离子对为：苯磺酸顺阿曲库铵464.3→358.2（m/z）、维库溴铵（IS）557.4→356.3（m/z）。收集老年脊柱手术患者麻醉诱导后、手术结束、术后0.5 h、术后1 h以及自体血回输时刻血袋内的血浆样品，于事先加入2%甲酸水溶液的冻存管中保存，测定样本中的苯磺酸顺阿曲库铵的含量，评估自体血回输对老年患者术后血浆苯磺酸顺阿曲库铵浓度的影响。结果 人血浆中苯磺酸顺阿曲库铵在20~5 000 ng/ml范围内线性良好，r=0.999 7；批内和批间的精密度RSD<10%、准确度RE<±10%；低中高3个浓度的基质效应为71.88%~80.64%、提取回收率为83.62%~88.87%，内标维库溴铵的提取回收率为125.91%，符合方法学要求。老年患者手术后血浆中有一定程度残留的苯磺酸顺阿曲库铵，需严格掌握拔管时间，适当延长患者在麻醉复苏室的停留时间。结论 该方法灵敏、准确、高效，适用于临床治疗中老年患者手术后血浆中苯磺酸顺阿曲库铵的含量测定。 |
| 中文关键词:超高效液相色谱-串联质谱 苯磺酸顺阿曲库铵 含量测定 残余肌松 |
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| Monitoring of residual cisatracurium besylate in elderly patients plasma at post operation by UPLC-MS/MS |
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| Abstract:Objective To establish a method for the determination of cisatracurium besylate in human plasma by UPLC-MS/MS which could be used in the monitoring of drug residual in plasma of elderly patients after operation. Methods The samples were precipitated with 0.1% formic acid-acetonitrile solution and separated by an SHISEIDO ADME column(3.0 mm×100 mm, 2.7 μm) for isocratic elution with the mobile phase of water containing 0.1% formic acid with 2 mmol/L ammonium acetate and acetonitrile (30:70, V/V). MS condition was optimized in the positive ion detection mode by multiple reaction monitoring (MRM), along with the Agilent jet stream electrospray source interface (AJS-ESI). The precursors to the product ion transitions were m/z 464.3→358.2 for cisatracurium besylate and m/z 557.4→356.3 for vecuronium bromide (the internal standard, IS). Plasma samples of elderly patients undergoing spinal surgery were collected after anesthesia induction, at the end of surgery, 0.5 h and 1 h after surgery, and from the blood bags while autologous blood transfusion, and stored in cryopreservation tubes with 2% formic acid solution. Then the contents of cisatracurium besylate were determined. The effects of autogenous blood transfusion on plasma concentration of cisatracurium besylate in elderly patients after surgery evaluated. Results The calibration curve was linear in the range of 20-5 000 ng/ml for cisatracurium besylate in human plasma, r=0.999 7. The intra-day and inter-day precision and accuracy were good (RSD<10%, RE<±10%). The matrix effect of different concentrations was 71.88%~80.64%. The recovery of different concentrations was 83.62%~88.87%. The recovery of vecuronium bromide (IS) was 125.91%, which conformed with the requirement of methodological validation. There was a certain degree of residual cisatracurium besylate in the plasma of elderly patients, so the extubation time should be strictly controlled and the stay time of patients in the anesthesia recovery room should be appropriately extended. Conclusion The method is sensitive, accurate, and efficient, which could be used for the determination of cisatracurium besylate in human plasma of elderly patients after operation. |
| keywords:UPLC-MS/MS cisatracurium besylate content determination residual curarization |
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