Rupieper N, Stöcker L
Anaesthesist. 1981 May;30(5):23-5.
Hemoglobin-(= Met-Hb)formation by local anaesthesia and local anaesthetics is still a point for discussion. Until now met-hb-aemia only was proven to develop under local anaesthetics with relationship to aniline (Benzocaine, Citanest). Since aniline does not possess any oxidative properties, met-hb-formation only can occur after metabolism (phenylhydroxylamine or para-aminophenol), first of all amino- and nitro-groups [6, 14] will be made responsible for oxidation. Because of the fact that neither the relationship to aniline nor the benzol-structure is the pre-supposition for met-hb-formation, possibly other substances with amino- or nitro-groups may induce it. In consequence of incidental cyanosis under intra and extradural analgesia we studied the met-hb-behaviour after the use of different local anaesthetics. The aniline-related bupivacaine and etidocaine were opposed to the thiophene-related carticaine. In this examination we found neither an elevation of hemoglobin by the aniline-related nor by the thiophene-related substances.
局部麻醉及局部麻醉药导致血红蛋白（即高铁血红蛋白）形成仍是一个有待探讨的问题。到目前为止，仅证实高铁血红蛋白血症在与苯胺相关的局部麻醉药（苯佐卡因、西他卡因）作用下会发生。由于苯胺不具备任何氧化特性，高铁血红蛋白的形成只能在代谢后（苯羟胺或对氨基苯酚）发生，首先氨基和硝基被认为是氧化的原因[6,14]。由于与苯胺的关系及苯环结构都不是高铁血红蛋白形成的前提条件，可能其他含有氨基或硝基的物质也会诱发其形成。鉴于在硬膜内和硬膜外镇痛过程中偶尔出现的发绀情况，我们研究了使用不同局部麻醉药后高铁血红蛋白的表现。将与苯胺相关的布比卡因和依替卡因与与噻吩相关的卡替卡因进行了对比。在这项研究中，我们发现与苯胺相关的物质以及与噻吩相关的物质均未使血红蛋白升高。
