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Accumulation of S(+) enantiomer in human beings after general anaesthesia with isoflurane racemate

Published online by Cambridge University Press:  16 August 2006

H. A. Haeberle ,
H. G. Wahl ,
H. Jakubetz ,
H. Krause ,
R. Schmidt ,
V. Schurig  and
H.-J. Dieterich
H. A. Haeberle
Affiliation:
Tuebingen University Hospital, Department of Anaesthesiology and Intensive Care Unit, Tuebingen, Germany
H. G. Wahl
Affiliation:
Tuebingen University Hospital, Department of Internal Medicine Tuebingen, Germany
H. Jakubetz
Affiliation:
Tuebingen University Hospital, Institute for Organic Chemistry, Tuebingen, Germany
H. Krause
Affiliation:
Tuebingen University Hospital, Department of Anaesthesiology and Intensive Care Unit, Tuebingen, Germany
R. Schmidt
Affiliation:
Tuebingen University Hospital, Institute for Organic Chemistry, Tuebingen, Germany
V. Schurig
Affiliation:
Tuebingen University Hospital, Institute for Organic Chemistry, Tuebingen, Germany
H.-J. Dieterich
Affiliation:
Tuebingen University Hospital, Department of Anaesthesiology and Intensive Care Unit, Tuebingen, Germany
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Abstract

Background and objective: Isoflurane is a chiral, volatile anaesthetic with low metabolic rate (0.17%) that is routinely administered in its racemic form. Knowledge about the distribution of the enantiomers in human beings may give some important information about the understanding of the mechanisms of volatile anaesthetics.

Methods: Blood samples were drawn immediately after tracheal extubation and daily up to 8 days postoperatively from patients undergoing general anaesthesia with isoflurane racemate. The enantiomer enrichment of isoflurane was determined by headspace gas chromatography-mass spectrometry.

Results: At all time points, there was a statistically significant accumulation of the S(+) enantiomer in blood, especially at days 2 (52.01%) and 7 (52.1%). Separate analysis of obese patients or in a small group of patients with co-existing lung disease did not show any difference to the total population. In addition, duration of anaesthesia did not influence the enantiomer concentrations.

Conclusions: We suggest that a slower association and dissociation rate is responsible for the S(+) enrichment.

Keywords

anaestheticsinhalationisofluraneisomerismstereoisomerismmolecular structure
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 19 , Issue 9 , September 2002 , pp. 641 - 646
Copyright
2002 European Society of Anaesthesiology

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