Detection of dexmedetomidine in human breast milk using liquid chromatography–tandem mass spectrometry: Application to a study of drug safety in breastfeeding after Cesarean section

Nakanishi, R.; Yoshimura, Manabu; Suno, Manabu; Yamamoto, Kento; Ito, Haruka; Uchimine, Yohei; Toriumi, Takashi; Kurosawa, Atsushi; Sugawara, Akira; Kunisawa, Takayuki

doi:10.1016/j.jchromb.2016.11.015

Cited by 23 publications

(19 citation statements)

References 17 publications

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“…Previous reports to quantify DXM have used methods of drug extraction such as direct protein precipitation [29], solid phase extraction [30–34] or liquid-liquid [35–37]. These reports require volumes of 100 to 1000 μL of plasma.…”

Section: Discussionmentioning

confidence: 99%

Determination of blood dexmedetomidine in dried blood spots by LC-MS/MS to screen therapeutic levels in paediatric patients

Rivera-Espinosa¹,

Toledo-López²,

Chávez‐Pacheco³

et al. 2019

PLoS ONE

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Dexmedetomidine is an imidazole derivative, with high affinity for α2 adrenergic receptors, used for sedation, analgesia and adjuvant anaesthesia. In this study, an analytical method for the quantification of dexmedetomidine in dried blood spots was developed, validated and applied. The drug was extracted from dried blood spot by liquid extraction; the separation was carried out by ultra high-resolution liquid chromatography in reverse phase coupled to tandem mass spectrometry method. An X Select cyano 5 μm HSS column (2.1 X 150 mm, Waters) and a mobile phase composed of 0.1% formic acid: acetonitrile [50:50 v/v], were used. The test was linear over the concentration range of 50 to 2000 pg/mL. The coefficients of variation for the intra and interday trials were less than 15%. The drug was stable under the conditions tested. The method was successfully applied for the quantification of 6 patients, aged 0 to 2 years, with classification ASA I, who underwent ambulatory surgeries, receiving a dose of 1 μg/Kg dexmedetomidine IV. The drug concentrations in the different sampling times were in the range of 76 to 868 pg/mL.

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Section: Discussionmentioning

confidence: 99%

Determination of blood dexmedetomidine in dried blood spots by LC-MS/MS to screen therapeutic levels in paediatric patients

Rivera-Espinosa¹,

Toledo-López²,

Chávez‐Pacheco³

et al. 2019

PLoS ONE

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“…Furthermore, it has the advantage of causing mild respiratory depression, even at higher doses. Previous studies have reported that DEX can both decrease the incidence of desaturation and reduce tracheobronchial secretions [ 26 ]. A general recommendation is a DEX bolus infusion of 1 μg·kg –1 for 10 min, followed by maintenance infusion at a rate of 0.2-0.7 μg·kg –1 ·h –1 , and SF infusion at 0.3 μg·kg –1 for 10 min, then adjusted to 0.1-0.3 μg·kg –1 ·h –1 for maintenance.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine plus sufentanil for pediatric flexible bronchoscopy: A retrospective clinical trial

Dang

Yang

et al. 2017

Oncotarget

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Several studies have reported the use of dexmedetomidine (DEX) plus opioids for flexible bronchoscopy in both adults and children. To determine whether DEX plus sufentanil (SF) is safe for children, 142 children undergoing flexible bronchoscopy were assigned to one of three groups, each of which received the same SF loading dose and similar DEX and SF maintenance doses, but different loading doses of DEX: DS1 (DEX 0.5 μg·kg–1), DS2 (DEX 1.0 μg·kg–1), and DS3 (DEX 1.5 μg·kg–1). The Ramsay sedation scale was maintained at 3 in all groups. Results showed that anesthesia onset time was shorter, and the perioperative hemodynamic profile was more stable, in the DS3 group. The number of intraoperative movements was also lowest in the DS3 group. The time to first dose of rescue midazolam and lidocaine was significantly longer, but the total corresponding accumulated doses were lower in the DS3 group. Although the time to recovery prior to discharge from the post anesthesia care unit was longer, the overall incidence of tachycardia was lower in the DS3 group, and it received the highest bronchoscopist satisfaction score among the three groups. We therefore conclude that high-dose DEX plus SF can be safely and efficaciously used in children undergoing flexible bronchoscopy.

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“…After centrifuging at 14,000 rpm for 5 min, 10 μL of the supernatant was injected for HPLC–MS/MS analysis. 18 …”

Section: Methodsmentioning

confidence: 99%

“… 14–17 Two previous studies investigated the safety of lactation with DEX; however, the sample sizes were small. 18 , 19 Nevertheless, the optimal dosage and safety of DEX used in combination with butorphanol for post-cesarean analgesia remain unclear.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness and Safety of Intravenous Dexmedetomidine of Different Concentrations Combined with Butorphanol for Post-Caesarean Section Analgesia: A Randomized Controlled Trial

Liu¹,

Peng²,

Hu³

et al. 2021

DDDT

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Purpose The present study aimed to determine the effectiveness of intravenous dexmedetomidine of different concentrations and to evaluate its maternal and neonatal safety when combined with butorphanol in parturients undergoing cesarean section. Patients and Methods A total of 114 parturients between 24 and 43 years of age, with singleton pregnancy who underwent elective cesarean section under epidural anesthesia, were randomly allocated to four groups: group C received 0.9% sodium chloride after delivery, followed by butorphanol (3 μg·kg −1 ·h −1 ); patients in groups D1, D2, and D3 received 0.5 μg·kg −1 ·h −1 dexmedetomidine after delivery, followed by butorphanol (3 μg·kg −1 ·h −1 ) combined with dexmedetomidine 0.03, 0.05, and 0.08 μg·kg −1 ·h −1 , respectively. The primary outcome was the visual analogue scale (VAS) score at 6 h after delivery when patients were at rest. Secondary outcome measures included VAS after delivery when patients were on movement and uterine cramping, Ramsay sedation scale (RSS), relative infant dose (RID) of dexmedetomidine, satisfaction with analgesia after surgery and symptoms of CNS depression in neonates. Results There were no significant differences in patient characteristics among the groups ( P > 0.05). The VAS at all timepoints after delivery in groups D2 and D3 were significantly lower than in groups C and D1 ( P < 0.001). RSS scores were clearly higher in group D3 than in the other three groups at 6 h and 12 h ( P < 0.0001). RID in groups D1, D2, and D3 was 0.171%, 0.197%, and 0.370%, respectively. Compared with group D1, RID was higher in group D3 ( P = 0.0079). Degree of satisfaction with analgesia was higher in groups D2 and D3 ( P < 0.005). Conclusion Continuous intravenous infusion of 0.05 μg·kg −1 ·h −1 dexmedetomidine combined with 3 μg·kg −1 ·h −1 butorphanol could be safely applied in healthy parturients with satisfactory analgesia after cesarean section without changes in sedation.

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Detection of dexmedetomidine in human breast milk using liquid chromatography–tandem mass spectrometry: Application to a study of drug safety in breastfeeding after Cesarean section

Cited by 23 publications

References 17 publications

Determination of blood dexmedetomidine in dried blood spots by LC-MS/MS to screen therapeutic levels in paediatric patients

Determination of blood dexmedetomidine in dried blood spots by LC-MS/MS to screen therapeutic levels in paediatric patients

Dexmedetomidine plus sufentanil for pediatric flexible bronchoscopy: A retrospective clinical trial

The Effectiveness and Safety of Intravenous Dexmedetomidine of Different Concentrations Combined with Butorphanol for Post-Caesarean Section Analgesia: A Randomized Controlled Trial

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