Kuhnert B R, Kuhnert P M, Reese A L, Philipson E H, Rosen M G
Anesth Analg. 1983 Dec;62(12):1089-94.
Little is known about the pharmacology of the metabolites of 2-chloroprocaine in obstetrical patients. The primary objective of this study was to describe the elimination of 2-chloroaminobenzoic acid (CABA) in maternal and neonatal urine after epidural anesthesia. A secondary objective was to compare its elimination in patients with preterm and term deliveries. The study included 21 pregnant women and their offspring. The mean gestational age of the 11 preterm infants was 34 +/- 3 weeks and that of the 10 term infants was 40 +/- 2 weeks. Maternal and cord venous blood samples were obtained at delivery and 12-hr urine samples for 72 hr postpartum. Blood and urine samples were analyzed for CABA by gas chromatography using electron capture detection. Both mothers and neonates excreted considerable amounts of unchanged CABA, and mothers also excreted CABA in a conjugated form. Mean elimination rate constants were 0.263 +/- 0.193 mg X hr-1 for mothers and 0.129 +/- 0.035 micrograms X hr-1 for neonates. Over 95% of the CABA recovered from the mothers and neonates was excreted by 36 hr postpartum. Mothers excreted 40% of the administered 2-chloroprocaine as CABA and neonates excreted 0.22-0.25% of the maternal dose as CABA. No differences in elimination due to the length of gestation were found in the mothers or neonates. Although mothers excrete CABA more rapidly than neonates, the results of this study suggest that both effectively excrete CABA.
关于2-氯普鲁卡因代谢产物在产科患者中的药理学，人们了解甚少。本研究的主要目的是描述硬膜外麻醉后母体和新生儿尿液中2-氯氨基苯甲酸（CABA）的消除情况。次要目的是比较早产和足月分娩患者中CABA的消除情况。该研究纳入了21名孕妇及其后代。11名早产儿的平均胎龄为34±3周，10名足月儿的平均胎龄为40±2周。在分娩时采集母体和脐带静脉血样本，并在产后72小时内采集12小时尿液样本。采用电子捕获检测气相色谱法分析血液和尿液样本中的CABA。母亲和新生儿均排泄出大量未变化的CABA，母亲还以结合形式排泄CABA。母亲的平均消除速率常数为0.263±0.193 mg·hr⁻¹，新生儿为0.129±0.035 μg·hr⁻¹。产后36小时内，从母亲和新生儿体内回收的CABA超过95%被排泄。母亲排泄出所给予2-氯普鲁卡因的40%作为CABA，新生儿排泄出母体剂量的0.22 - 0.25%作为CABA。未发现母亲或新生儿因妊娠期长短而在消除方面存在差异。尽管母亲排泄CABA的速度比新生儿快，但本研究结果表明两者均能有效排泄CABA。
