Hino Y, Inoue H, Kudo K, Nishida N, Ikeda N
Department of Forensic Pathology and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Forensic Sci Int. 2001 Dec 27;124(2-3):130-6. doi: 10.1016/s0379-0738(01)00585-0.
High spinal anesthesia is one cause of sudden death associated with the spinal anesthesia. We did animal experiments to verify high spinal anesthesia by analyzing tetracaine and its metabolite, p-butylaminobenzoic acid in tissue samples. Tetracaine (0.25% in 10% glucose solution) 0.21-0.28 mg/kg was administered to two groups of rabbits to induce high and normal spinal anesthesia. Tetracaine and the metabolite in rabbit tissues were analyzed by gas chromatography-mass spectrometry, as a free base for tetracaine and as tert-butyldimethylsilyl derivative for the metabolite. In the group given high spinal anesthesia, levels of the metabolite in the brain stem were higher than in the cerebrum, cerebellum and whole blood. On the other hand, in the group given normal spinal anesthesia, the opposite results were obtained. Therefore, high spinal anesthesia induced by tetracaine can be diagnosed by comparing the concentrations of metabolite in whole blood, cerebrum, cerebellum and brain stem.
高位脊髓麻醉是与脊髓麻醉相关的猝死原因之一。我们通过分析组织样本中的丁卡因及其代谢产物对氨基苯甲酸丁酯来进行动物实验以验证高位脊髓麻醉。将两组兔子分别给予0.21 - 0.28毫克/千克的丁卡因（10%葡萄糖溶液中0.25%）以诱导高位和正常脊髓麻醉。采用气相色谱 - 质谱法分析兔组织中的丁卡因及其代谢产物，丁卡因以游离碱形式分析，代谢产物以叔丁基二甲基硅烷基衍生物形式分析。在给予高位脊髓麻醉的组中，脑干中代谢产物的水平高于大脑、小脑和全血中的水平。另一方面，在给予正常脊髓麻醉的组中，得到了相反的结果。因此，通过比较全血、大脑、小脑和脑干中代谢产物的浓度可以诊断丁卡因诱导的高位脊髓麻醉。
