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Simultaneous determination of fluorinated inhalation anesthetics in blood by gas chromatography–mass spectrometry combined with a headspace autosampler
Authors:N C Yang  K L Hwang  C H Shen  H F Wang  W M Ho  
Institution:a Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan;b Department of Medical Education and Research, Changhua Christian Hospital, Changhua, Taiwan;c Department of Anesthesiology, Chung-Shan Medical and Dental College, Taichung, Taiwan
Abstract:Although the fluorinated inhalation anesthetics, including desflurane, sevoflurane, isoflurane, enflurane, and halothane are commonly used, fatal cases resulting from their abuse or misuse have been reported. To date, gas chromatography (GC) equipped with different kinds of detectors has been utilized to analyze inhalation anesthetics. However, none of them can detect desflurane reliably or analyze all five common anesthetics simultaneously. The purpose of the present work is to further modify the previously developed headspace (HS) GC–MS method for blood isoflurane determination to analyze and distinguish five common clinical inhalation anesthetics, simultaneously. The modified HS-GC–MS method adopts a 60 m×0.25 mm I.D., 0.25 μm film thickness DB-5 capillary column along with an adequate GC temperature program, which gives the five inhalation anesthetics, including isoflurane and its isomer, enflurane, a high resolution. The method also takes both the volatility and the influence of the top space on the obtained concentration into consideration and therefore keeps the sample loss acceptable even for analyzing the highly volatile desflurane. Within a certain concentration range of the calibration standard (about 20–300 μg/ml), this method shows a good linearity with correlation coefficients greater than 0.999. In addition, both within- and between-run precision and accuracy results meet the validation requirements as well as the tested results of practical blood samples of desflurane. In summary, this is a reliable analytical method to simultaneously determine the concentration of five common inhalation anesthetics in blood. Such a method is very practical for both clinical and occupational monitoring, as well as for analytical toxicology.
Keywords:Desflurane  Sevoflurane  Isoflurane  Enflurane  Halothane
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