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1.
J Pharm Biomed Anal ; 164: 421-429, 2019 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-30445355

RESUMEN

Herein we describe for the first time the endogenous levels of free l-and d-amino acids in cultured human breast cancer cells (MCF-7) and non-tumorigenic human breast epithelial cells (MCF-10A). d-Asp and d-Ser, which are co-agonists of the N-methyl-d-aspartate (NMDA) receptors, showed significantly elevated levels in MCF-7 cancer cells compared to MCF-10A cells. This may result from upregulated enzymatic racemases. Possible roles of these d-amino acids in promoting breast cancer proliferation by regulating NMDA receptors were indicated. d-Asn may also be able to serve as exchange currency, like specific l-amino acids, for the required uptake of essential amino acids and other low abundance nonessential amino acids which were elevated nearly 60 fold in cancer cells. The relative levels of specific l- and d-amino acids can be used as malignancy indicators (MIs) for the breast cancer cell line in this study. High MIs (>50) result from the increased demands of specific essential amino acids. Very low MIs (<1) result from the increased demands of specific d-amino acids (i.e., d-Ser, d-Asp) or the cellular release of amino acid exchange currency (i.e., l- and d-Asn) used in the upregulated amino acid antiporters to promote cancer cell proliferation.


Asunto(s)
Aminoácidos/análisis , Antiportadores/metabolismo , Biomarcadores de Tumor/análisis , Neoplasias de la Mama/metabolismo , Aminoácidos/química , Aminoácidos/metabolismo , Biomarcadores de Tumor/química , Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/genética , Proliferación Celular/genética , Células Epiteliales , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Células MCF-7 , Metabolómica/instrumentación , Metabolómica/métodos , Estereoisomerismo , Regulación hacia Arriba
2.
Electrophoresis ; 40(4): 539-546, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30450594

RESUMEN

The combined use of chiral ionic liquids (CILs) and conventional chiral selectors (CSs) in CE, to establish a synergistic system, has proven to be an effective approach for the separation of enantiomeric pairs. In this study, a new CE method was developed, employing a binary system of a CS, either a cyclodextrin (CD) or a cyclofructan (CF), and a chiral amino acid ester-based ionic liquid (AAIL), for the chiral separation of four basic, acidic and zwitterionic drug compounds. In particular, the enantioseparation of two anticoagulants, warfarin (WAR) and coumachlor (COU), a non-opioid analgesic, nefopam (NEF) and a third-generation antihistamine, fexofenadine (FXD), was examined, by supporting the BGE with a CS and the chiral AAIL L-alanine tert butyl ester lactate (L-AlaC4 Lac). Parameters, such as the type of the CS, the concentration of both the CS and L-AlaC4 Lac, and the BGE pH, were methodically examined in order to optimize the chiral separation of each analyte. It was observed that, in some cases, the addition of the AAIL into the BGE improved both resolution (Rs ) and efficiency (N) significantly. In other cases, the synergistic effect enabled baseline separation of analyte enantiomers, at a much lower concentration of the CS. Finally, after optimization of separation conditions, baseline separations (Rs >1.5) of all four analytes were achieved in less than 5 min.


Asunto(s)
Ciclodextrinas/química , Electroforesis Capilar/métodos , Fructanos/química , Líquidos Iónicos , Alanina/química , Concentración de Iones de Hidrógeno , Líquidos Iónicos/química , Líquidos Iónicos/aislamiento & purificación , Lactatos/química , Preparaciones Farmacéuticas/química , Preparaciones Farmacéuticas/aislamiento & purificación , Estereoisomerismo
3.
Chirality ; 30(9): 1067-1078, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29969166

RESUMEN

A modified macrocyclic glycopeptide-based chiral stationary phase (CSP), prepared via Edman degradation of vancomycin, was evaluated as a chiral selector for the first time. Its applicability was compared with other macrocyclic glycopeptide-based CSPs: TeicoShell and VancoShell. In addition, another modified macrocyclic glycopeptide-based CSP, NicoShell, was further examined. Initial evaluation was focused on the complementary behavior with these glycopeptides. A screening procedure was used based on previous work for the enantiomeric separation of 50 chiral compounds including amino acids, pesticides, stimulants, and a variety of pharmaceuticals. Fast and efficient chiral separations resulted by using superficially porous (core-shell) particle supports. Overall, the vancomycin Edman degradation product (EDP) resembled TeicoShell with high enantioselectivity for acidic compounds in the polar ionic mode. The simultaneous enantiomeric separation of 5 racemic profens using liquid chromatography-mass spectrometry with EDP was performed in approximately 3 minutes. Other highlights include simultaneous liquid chromatography separations of rac-amphetamine and rac-methamphetamine with VancoShell, rac-pseudoephedrine and rac-ephedrine with NicoShell, and rac-dichlorprop and rac-haloxyfop with TeicoShell.


Asunto(s)
Antibacterianos/química , Cromatografía Líquida de Alta Presión/instrumentación , Vancomicina/química , Cromatografía Líquida de Alta Presión/métodos , Espectrometría de Masas/métodos , Espectrofotometría Ultravioleta , Estereoisomerismo
4.
Anal Chem ; 90(13): 8139-8146, 2018 07 03.
Artículo en Inglés | MEDLINE | ID: mdl-29893545

RESUMEN

Geopolymers belong to an interesting class of X-ray amorphous polycondensed aluminosilicate ceramic solids. The high mechanical strength, chemical stability in basic conditions, and water insolubility make geopolymers a unique solid support in separation science. This work describes a new straightforward synthetic procedure for making spherical porous geopolymer particles with high surface area which are amenable for chromatographic purposes. In-depth physicochemical evaluation of geopolymers is conducted via particle size distribution, porosity measurements, X-ray diffraction, pH titration, and energy-dispersive spectroscopy and compared with silica, titania, and zirconia. Chromatographic selectivity shows that the surface chemistry of geopolymers has strong hydrophilic and electrostatic character, which makes it different from 36 chromatographic columns. Hydrophilic interaction liquid chromatography in columns packed with geopolymer particles shows different selectivity than that in silica columns, with excellent peak shapes. Phosphate or fluoride additives are not required as they are for zirconia or titania phase.

5.
J Pharm Biomed Anal ; 155: 70-81, 2018 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-29625259

RESUMEN

Core-shell particles (superficially porous particles, SPPs) have been proven to provide high-throughput and effective separations of a variety of chiral molecules. However, due to their limited commercialization, many separations have not been reported with these stationary phases. In this study, four SPP chiral stationary phases (CSPs) were utilized for the enantiomeric separation of 150 chiral amines. These amines encompass a variety of structural and drug classes, which are particularly important to the pharmaceutical industry and in forensics. This comprehensive evaluation demonstrates the power of these CSPs and the ease of method development and optimization. The CSPs used in this study included the macrocyclic glycopeptide-based CSPs (VancoShell and NicoShell), the cyclodextrin-based CSP (CDShell-RSP), and the cyclofructan-based CSP (LarihcShell-P). These CSPs offered versatility for a variety of applications and worked in a complementary fashion to baseline separate all 150 amines. The LarihcShell-P was highly effective for separating primary amines. VancoShell, NicoShell, and CDShell-RSP were useful for separating all types of amines. These CSPs are multi-modal and can be utilized with mass spectrometry compatible solvents. Eighteen racemic controlled substances were simultaneously baseline separated in a single liquid chromatography-mass spectrometry (LC-MS) analysis. Details in high-performance liquid chromatography (HPLC) parameters will be discussed as well as the improved chromatographic performance afforded by the SPP CSPs.


Asunto(s)
Aminas/química , Preparaciones Farmacéuticas/química , Cromatografía Líquida de Alta Presión/métodos , Ciclodextrinas/química , Fructanos/química , Glicopéptidos/química , Compuestos Macrocíclicos/química , Espectrometría de Masas/métodos , Porosidad , Estereoisomerismo
6.
Anal Bioanal Chem ; 410(12): 2971-2979, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29532193

RESUMEN

D-amino acids are now recognized to be widely present in organisms and play essential roles in biological processes. Some D-amino acids are metabolized by D-amino acid oxidase (DAO), while D-Asp and D-Glu are metabolized by D-aspartate oxidase (DDO). In this study, levels of 22 amino acids and the enantiomeric compositions of the 19 chiral proteogenic entities have been determined in the whole brain of wild-type ddY mice (ddY/DAO+/+), mutant mice lacking DAO activity (ddY/DAO-/-), and the heterozygous mice (ddY/DAO+/-) using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). No significant differences were observed for L-amino acid levels among the three strains except for L-Trp which was markedly elevated in the DAO+/- and DAO-/- mice. The question arises as to whether this is an unknown effect of DAO inactivity. The three highest levels of L-amino acids were L-Glu, L-Asp, and L-Gln in all the three strains. The lowest L-amino acid level was L-Cys in ddY/DAO+/- and ddY/DAO-/- mice, while L-Trp showed the lowest level in ddY/DAO+/+mice. The highest concentration of D-amino acid was found to be D-Ser, which also had the highest % D value (~ 25%). D-Glu had the lowest % D value (~ 0.01%) in all the three strains. Significant differences of D-Leu, D-Ala, D-Ser, D-Arg, and D-Ile were observed in ddY/DAO+/- and ddY/DAO-/- mice compared to ddY/DAO+/+ mice. This work provides the most complete baseline analysis of L- and D-amino acids in the brains of ddY/DAO+/+, ddY/DAO+/-, and ddY/DAO-/- mice yet reported. It also provides the most effective and efficient analytical approach for measuring these analytes in biological samples. This study provides fundamental information on the role of DAO in the brain and may be relevant for future development involving novel drugs for DAO regulation.


Asunto(s)
Aminoácidos/análisis , Química Encefálica , D-Aminoácido Oxidasa/genética , Eliminación de Gen , Animales , Cromatografía Líquida de Alta Presión/economía , Cromatografía Líquida de Alta Presión/métodos , Femenino , Masculino , Ratones , Estereoisomerismo , Espectrometría de Masas en Tándem/economía , Espectrometría de Masas en Tándem/métodos
7.
Talanta ; 181: 132-141, 2018 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-29426492

RESUMEN

The predominant enantiomer of nicotine found in nature is (S)-nicotine and its pharmacology has been widely established. However, pharmacologic information concerning individual enantiomers of nicotine-related compounds is limited. Recently, a modified macrocyclic glycopeptide chiral selector was found to be highly stereoselective for most tobacco alkaloids and metabolites. This study examines the semi-synthetic and native known macrocyclic glycopeptides for chiral recognition, separation, and characterization of the largest group of nicotine-related compounds ever reported (tobacco alkaloids, nicotine metabolites and derivatives, and tobacco-specific nitrosamines). The enantioseparation of nicotine is accomplished in less than 20s for example. All liquid chromatography separations are mass spectrometry compatible for the tobacco alkaloids, as well as their metabolites. Ring-closed, cyclized structures were identified and separated from their ring-open, straight chain equilibrium structures. Also, E/Z-tobacco-specific nitrosamines and their enantiomers were directly separated. E/Z isomers also are known to have different physical and chemical properties and biological activities. This study provides optimal separation conditions for the analysis of nicotine-related isomers, which in the past have been reported to be ineffectively separated which can result in inaccurate results. The methodology of this study could be applied to cancer studies, and lead to more information about the role of these isomers in other diseases and as treatment for diseases.


Asunto(s)
Alcaloides/química , Carcinógenos/química , Nicotiana/química , Nitrosaminas/química , Alcaloides/aislamiento & purificación , Alcaloides/metabolismo , Carcinógenos/aislamiento & purificación , Carcinógenos/metabolismo , Cromatografía Liquida/métodos , Glicopéptidos/química , Espectrometría de Masas/métodos , Nicotina/química , Nicotina/aislamiento & purificación , Nicotina/metabolismo , Nitrosaminas/aislamiento & purificación , Nitrosaminas/metabolismo , Reproducibilidad de los Resultados , Estereoisomerismo
8.
ACS Chem Neurosci ; 8(6): 1251-1261, 2017 06 21.
Artículo en Inglés | MEDLINE | ID: mdl-28206740

RESUMEN

The l-enantiomer is the predominant type of amino acid in all living systems. However, d-amino acids, once thought to be "unnatural", have been found to be indigenous even in mammalian systems and increasingly appear to be functioning in essential biological and neurological roles. Both d- and l-amino acid levels in the hippocampus, cortex, and blood samples from NIH Swiss mice are reported. Perfused brain tissues were analyzed for the first time, thereby eliminating artifacts due to endogenous blood, and decreased the mouse-to-mouse variability in amino acid levels. Total amino acid levels (l- plus d-enantiomers) in brain tissue are up to 10 times higher than in blood. However, all measured d-amino acid levels in brain tissue are typically ∼10 to 2000 times higher than blood levels. There was a 13% reduction in almost all measured d-amino acid levels in the cortex compared to those in the hippocampus. There is an approximate inverse relationship between the prevalence of an amino acid and the percentage of its d-enantiomeric form. Interestingly, glutamic acid, unlike all other amino acids, had no quantifiable level of its d-antipode. The bioneurological reason for the unique and conspicuous absence/removal of this d-amino acid is yet unknown. However, results suggest that d-glutamate metabolism is likely a unidirectional process and not a cycle, as per the l-glutamate/glutamine cycle. The results suggest that there might be unreported d-amino acid racemases in mammalian brains. The regulation and function of specific other d-amino acids are discussed.


Asunto(s)
Aminoácidos/química , Química Encefálica , Aminoácidos/análisis , Animales , Encéfalo/metabolismo , Ratones , Estereoisomerismo
9.
Drug Test Anal ; 9(6): 944-948, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27943582

RESUMEN

Recently, a variety of new tobacco-free-nicotine, TFN, products have been commercialized as e-liquids. Tobacco-derived nicotine contains predominantly (S)-(-)-nicotine, whereas TFN products may not. The TFN products are said to be cleaner, purer substances, devoid of toxic components that come from the tobacco extraction process. A variety of commercial tobacco and TFN products were analyzed to identify the presence and composition of each nicotine enantiomer. A rapid and effective enantiomeric separation of nicotine has been developed using a modified macrocyclic glycopeptide bonded to superficially porous particles. The enantiomeric assay can be completed in <2 min with high resolution and accuracy using high performance liquid chromatography with electrospray ionization mass spectrometry. The results of this study suggest the need for pharmacological studies of (R)-(+)-nicotine, which is present in much greater quantities in commercial TFN products compared to commercial tobacco-derived products. Such studies are required by the FDA for new enantiomeric pharmacological products. Copyright © 2016 John Wiley & Sons, Ltd.


Asunto(s)
Nicotina/análisis , Agonistas Nicotínicos/análisis , Cromatografía Líquida de Alta Presión , Sistemas Electrónicos de Liberación de Nicotina , Glicopéptidos/química , Espectrometría de Masa por Ionización de Electrospray , Estereoisomerismo , Nicotiana/química
10.
J Agric Food Chem ; 64(6): 1422-32, 2016 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-26852774

RESUMEN

Four ionic liquid (IL) columns, SLB-IL59, SLB-IL60, SLB-IL65, and SLB-IL111, were evaluated for more rapid analysis or improved resolution of long-chain methyl and ethyl esters of omega-3, omega-6, and additional positional isomeric and stereoisomeric blends of fatty acids found in fish oil, flaxseed oil, and potentially more complicated compositions. The three structurally distinct IL columns provided shorter retention times and more symmetric peak shapes for the fatty acid methyl or ethyl esters than a conventional polyethylene glycol column (PEG), resolving cis- and trans-fatty acid isomers that coeluted on the PEG column. The potential for improved resolution of fatty acid esters is important for complex food and supplement applications, where different forms of fatty acid can be incorporated. Vacuum ultraviolet detection contributed to further resolution for intricate mixtures containing cis- and trans-isomers, as exemplified in a fatty acid blend of shorter chain C18:1 esters with longer chain polyunsaturated fatty acid (PUFA) esters.


Asunto(s)
Cromatografía de Gases/métodos , Ácidos Grasos Insaturados/química , Suplementos Dietéticos/análisis , Ésteres/análisis , Aceites de Pescado/química , Estereoisomerismo
11.
Artículo en Inglés | MEDLINE | ID: mdl-24910297

RESUMEN

The enantiomeric separation of a series of racemic functionalized ethano-bridged Tröger base compounds was examined by high performance liquid chromatography (HPLC) and capillary electrophoresis (CE). Using HPLC and CE the entire set of 14 derivatives was separated by chiral stationary phases (CSPs) and chiral additives composed of cyclodextrin (native and derivatized) and cyclofructan (derivatized). Baseline separations (Rs ≥ 1.5) in HPLC were achieved for 13 of the 14 compounds with resolution values as high as 5.0. CE produced 2 baseline separations. The separations on the cyclodextrin CSPs showed optimum results in the reversed phase mode, and the LARIHC cyclofructan CSPs separations showed optimum results in the normal phase mode. HPLC separation data of the compounds was analyzed using principal component analysis (PCA). The PCA biplot analysis showed that retention is governed by the size of the R1 substituent in the case of derivatized cyclofructan and cyclodextrin CSPs, and enantiomeric resolution closely correlated with the size of the R2 group in the case of non-derivatized γ-cyclodextrin CSP. It is clearly shown that chromatographic retention is necessary but not sufficient for the enantiomeric separations of these compounds.

12.
Artículo en Inglés | MEDLINE | ID: mdl-24631813

RESUMEN

The enantiomeric separation of a series of racemic functionalized ethano-bridged Tröger base compounds was examined by high performance liquid chromatography (HPLC) and capillary electrophoresis (CE). Using HPLC and CE the entire set of 14 derivatives was separated by chiral stationary phases (CSPs) and chiral additives composed of cyclodextrin (native and derivatized) and cyclofructan (derivatized). Baseline separations (Rs≥1.5) in HPLC were achieved for 13 of the 14 compounds with resolution values as high as 5.0. CE produced 2 baseline separations. The separations on the cyclodextrin CSPs showed optimum results in the reversed phase mode, and the LARIHC™ cyclofructan CSPs separations showed optimum results in the normal phase mode. HPLC separation data of the compounds was analyzed using principal component analysis (PCA). The PCA biplot analysis showed that retention is governed by the size of the R1 substituent in the case of derivatized cyclofructan and cyclodextrin CSPs, and enantiomeric resolution closely correlated with the size of the R2 group in the case of non-derivatized γ-cyclodextrin CSP. It is clearly shown that chromatographic retention is necessary but not sufficient for the enantiomeric separations of these compounds.


Asunto(s)
Azocinas/química , Azocinas/aislamiento & purificación , Cromatografía Líquida de Alta Presión/métodos , Ciclodextrinas/química , Electroforesis Capilar/métodos , Fructanos/química , Azocinas/análisis , Análisis de Componente Principal , Estereoisomerismo
13.
J Pharm Biomed Anal ; 94: 111-7, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24561336

RESUMEN

A rapid, accurate, precise and versatile analytical method was developed for the detection and quantification of water in solid active pharmaceutical ingredients (APIs). The headspace gas chromatography (HSGC) method utilized an ionic liquid (IL) based open tubular capillary GC column to increase sensitivity and ruggedness of this method. ILs are also utilized as the headspace solvent because of their low vapor pressure, unique physiochemical properties and high thermal stability. This method is not affected by side reactions and solubility problems which are common with Karl Fischer Titration (KFT) methods. Nor is it as limited as weight loss on drying approaches. The ability to use either/both modern thermal conductivity or barrier ion discharge GC detection provides flexibility, different dynamic ranges and sensitivity. The developed method also was shown to be broadly applicable.


Asunto(s)
Líquidos Iónicos/química , Preparaciones Farmacéuticas/química , Agua/química , Cromatografía de Gases/métodos , Estabilidad de Medicamentos , Iones/química , Sensibilidad y Especificidad , Solubilidad , Temperatura , Conductividad Térmica
14.
J Agric Food Chem ; 62(8): 1832-8, 2014 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-24527961

RESUMEN

Analysis of ethanol and water in consumer products is important in a variety of processes and often is mandated by regulating agencies. A method for the simultaneous quantitation of ethanol and water that is simple, accurate, precise, rapid, and cost-effective is demonstrated. This approach requires no internal standard for the quantitation of both ethanol and water at any/all levels in commercial products. Ionic liquid based gas chromatography (GC) capillary columns are used to obtain a fast analysis with high selectivity and resolution of water and ethanol. Typical run times are just over 3 min. Examination of the response range of water and ethanol with GC, thermal conductivity detection (TCD), and barrier ionization detection (BID) is performed. Quantitation of both ethanol and water in consumer products is accomplished with both TCD and BID GC detectors using a nonlinear calibration. Validation of method accuracy is accomplished by using standard reference materials.


Asunto(s)
Cromatografía de Gases/métodos , Etanol/análisis , Análisis de los Alimentos/métodos , Agua/análisis , Cromatografía de Gases/instrumentación , Análisis de los Alimentos/instrumentación , Líquidos Iónicos/química , Conductividad Térmica
15.
J Sep Sci ; 37(5): 558-65, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24415651

RESUMEN

In contrast to the plethora of publications on the separation of fatty acids, analogous studies involving fatty amines are scarce. A recently introduced ionic-liquid-based capillary column for GC was used to separate trifluoroacetylated fatty amines focusing on the analysis of a commercial sample. Using the ionic liquid column (isothermal mode at 200 °C) it was possible to separate linear primary fatty amines from C12 to C22 chain length in less 25 min with MS identification. The log of the amine retention factors are linearly related to the alkyl chain length with a methylene selectivity of 0.117 kcal/mol for the saturated amines and 0.128 kcal/mol for the mono-unsaturated amines. The sp2 selectivity for unsaturated fatty amines also could be calculated as 0.107 kcal/mol for the ionic liquid column. The commercial sample was quantified by GC with flame ionization detection (FID). An LC method also was developed with a reversed phase gradient separation using acetonitrile/formate buffer mobile phases and ESI-MS detection. Native amines could be detected and identified by their single ion monitoring chromatograms even when partial coelution was observed. The analysis of the commercial sample returned results coherent with those obtained by GC-FID and with the manufacturer's data.


Asunto(s)
Aminas/química , Cromatografía de Gases/métodos , Cromatografía Liquida/métodos , Ácidos Grasos/química , Estructura Molecular , Espectrometría de Masa por Ionización de Electrospray
16.
Anaesthesia ; 57(4): 330-3, 2002 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11939990

RESUMEN

Sixty-one patients received a standardised anaesthetic and were randomly assigned to three groups: tracheal intubation via direct laryngoscopy, tracheal intubation via an intubating laryngeal mask airway with immediate removal of the device, and tracheal intubation via an intubating laryngeal mask airway with delayed removal. The cardiovascular response to intubation was of a similar magnitude in all groups, although delayed removal of the intubating laryngeal mask airway was associated with a second pressor response. Norepinephrine changed significantly over time following direct laryngoscopy and following immediate removal of the intubating laryngeal mask airway, but not after delayed removal. The findings of this study do not support using the intubating laryngeal mask instead of direct laryngoscopy purely to decrease the response to intubation.


Asunto(s)
Presión Sanguínea , Frecuencia Cardíaca , Máscaras Laríngeas , Adulto , Anestesia General , Remoción de Dispositivos , Epinefrina/sangre , Femenino , Humanos , Intubación Intratraqueal/métodos , Laringoscopía , Masculino , Persona de Mediana Edad , Norepinefrina/sangre , Estudios Prospectivos , Método Simple Ciego , Factores de Tiempo
17.
Eur J Anaesthesiol ; 18(7): 471-5, 2001 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-11437876

RESUMEN

BACKGROUND AND OBJECTIVE: The intubating laryngeal mask (intubating laryngeal mask airway) was designed to facilitate blind intubation. Its value as an adjunct to fibreoptic laryngoscopy has not been evaluated. This study compares the intubating laryngeal mask airway with the standard laryngeal mask airway as conduits for fibreoptic laryngoscopy. METHODS: The fibreoptic view of the laryngeal inlet was graded via both devices in 60 anaesthetized patients. The fibreoptic view through the intubating laryngeal mask airway was assessed after the central epiglottic elevator bar had been lifted out of the field of vision by an 8-mm Euromedical tracheal tube, which was inserted to a depth of 18 cm. The fibreoptic view from the aperture bars of the laryngeal mask was recorded. RESULTS: The vocal cords were viewed less frequently through the intubating laryngeal mask airway (52%) than through the laryngeal mask airway (92%) [difference = 40% (95% CI = 26% to 54%), P < 0.0001]. CONCLUSION: The view of the laryngeal inlet is better through the laryngeal mask airway than through a tracheal tube inserted to 18 cm in the intubating laryngeal mask.


Asunto(s)
Intubación Intratraqueal , Máscaras Laríngeas , Laringoscopios , Laringoscopía/métodos , Adolescente , Adulto , Cartílago Aritenoides/anatomía & histología , Epiglotis/anatomía & histología , Femenino , Tecnología de Fibra Óptica , Humanos , Masculino , Persona de Mediana Edad , Pliegues Vocales/anatomía & histología
18.
Anaesthesia ; 56(4): 357-60, 2001 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11284824

RESUMEN

Twenty-four inexperienced participants were timed inserting the intubating laryngeal mask airway and the laryngeal mask airway in 75 anaesthetised subjects. Adequacy of ventilation was assessed on a three-point scale. The pressure at which a leak first developed around the device's cuff was also measured. There was no significant difference in insertion time or the likelihood of achieving adequate ventilation between devices. However, the intubating laryngeal mask airway was better at providing adequate ventilation without audible leak (58/75 (77%) vs. 42/75 (56%); p = 0.009). The median (range [IQR]) pressure at which an audible leak developed was higher for the intubating laryngeal mask airway, 34.5 (14-40 [29-40]) cmH2O, than for the laryngeal mask airway, 27.5 (14-40 [22-33]) cmH2O (p < 0.001). The intubating laryngeal mask airway is worthy of further consideration as a tool for emergency airway management for inexperienced personnel.


Asunto(s)
Competencia Clínica , Máscaras Laríngeas , Adolescente , Adulto , Anciano , Anestesia General , Actitud del Personal de Salud , Comportamiento del Consumidor , Femenino , Humanos , Intubación Intratraqueal/instrumentación , Masculino , Persona de Mediana Edad , Respiración Artificial , Factores de Tiempo
19.
Reg Anesth Pain Med ; 26(2): 100-4, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11251131

RESUMEN

BACKGROUND AND OBJECTIVES: To quantify the motor threshold current of a needle following elicitation of paresthesia during axillary brachial plexus block (ABPB). METHODS: This is a prospective, observational study of ABPB in 72 patients. Having elicited paresthesia, the minimum current required to produce a motor response was noted. The development and success of the block were subsequently followed. RESULTS: Nineteen blocks were excluded (18 because of arterial puncture and 1 blocked needle). Of the remaining 53 blocks, 41 (77%) produced a motor response at 0.5 mA or less. The median current was 0.17 mA (range, 0.03 to 3.3 mA). The site of initial paresthesia and subsequent motor response were related in 43 (81%) of cases. CONCLUSIONS: A needle position causing paresthesia produced a motor response at 0.5 mA or less in 77% of cases studied. This current may, therefore, be a reasonable threshold to aim for when performing an ABPB.


Asunto(s)
Axila , Plexo Braquial , Bloqueo Nervioso , Parestesia , Anestésicos Locales , Brazo , Estimulación Eléctrica , Potenciales Evocados Motores , Humanos , Lidocaína , Persona de Mediana Edad , Músculo Esquelético/inervación , Bloqueo Nervioso/métodos , Parestesia/etiología , Estudios Prospectivos , Umbral Sensorial
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