Sharp J H, Trudell J R, Cohen E N
Anesthesiology. 1979 Jan;50(1):2-8. doi: 10.1097/00000542-197901000-00002.
The presence of two volatile halothane metabolites, 2-chloro-1,1,1-trifluoroethane (CF3CH2Cl) and 2-chloro-1,1-difluoroethylene (CF2CHCl), and a metabolite-decomposition product, 2-bromo-2-chloro-1,1-difluoroethylene (CF2CBrCl), were identified by gas chromatography-mass spectrometry in exhaled gases of 16 patients anesthetized with halothane in nonrebreathing, semiclosed and totally closed anesthesia circuits. No significant differences in concentrations of CF3CH2Cl and CF2CHCl were found relative to the anesthesia circuits used. CF2CBrCl could not be identified in the expired gases of patients anesthetized with a nonrebreathing circuit (Bain), but was present in gases recovered from both semiclosed and totally closed circuits. Under totally closed-circuit rebreathing conditions, the concentration of CF2CBrCl increased to 4-5 ppm, indicating significant breakdown of halothane by the soda lime. Possible pathways for formation of the two metabolites and the metabolite-decomposition product are presented, as well as clinical implications of these findings.
通过气相色谱-质谱法在16例使用氟烷麻醉的患者呼出气体中鉴定出两种挥发性氟烷代谢物,即2-氯-1,1,1-三氟乙烷(CF3CH2Cl)和2-氯-1,1-二氟乙烯(CF2CHCl),以及一种代谢物分解产物,即2-溴-2-氯-1,1-二氟乙烯(CF2CBrCl)。这些患者分别在无重复吸入、半封闭和全封闭麻醉回路中接受氟烷麻醉。相对于所使用的麻醉回路,未发现CF3CH2Cl和CF2CHCl浓度存在显著差异。在使用无重复吸入回路(贝恩回路)麻醉的患者呼出气体中未鉴定出CF2CBrCl,但在从半封闭和全封闭回路回收的气体中均有存在。在全封闭回路再呼吸条件下,CF2CBrCl浓度增加至4 - 5 ppm,表明氟烷被碱石灰大量分解。文中介绍了两种代谢物和代谢物分解产物的可能形成途径,以及这些发现的临床意义。