Abstract

Remifentanil is an ultra-short-acting synthetic opioid-class analgesic which might be increasingly used “off-label” as pain management during labour. Side effects in parturients during labour, and in the infant at birth are of particular concern, especially respiratory depression which is concentration-dependent, and can occur at levels as low as 3–5 ng mL–1. The safety of such use, particularly in newborns due to remifentanil placental transfer, has not been fully demonstrated yet, partly due to the lack of a suitable non-invasive analytical method. The aim of our work was to develop a sensitive method to monitor the levels of remifentanil in neonates by a non-invasive sampling of umbi lical cord blood to support efficacy and safety trials. The presented LC-MS method is sensitive enough to reliably quantify remifentanil in just 20 µL of blood at only 0.3 ng mL–1. The dried blood spot sample preparation included solvent extraction with subsequent solid-phase extraction. The method was validated in terms of accuracy, precision, recovery, matrix effect, and stability, and was successfully applied to a small pilot study. The estimated arterial blood concentrations at the time of delivery ranged from 0.2 to 0.3, and up to 0.9 ng mL–1 in neonatal, and maternal samples, respectively.

Details

Title
Determination of remifentanil in neonatal dried blood spots by liquid chromatography-tandem mass spectrometry
Author
Trontelj, Jurij 1 ; Rozman, Aleš 2 ; Mrhar, Aleš 1 

 University of Ljubljana, Faculty of Pharmacy 1000 Ljubljana, Slovenia 
 Gynecology and Obstetrics Hospital Kranj, 4000 Kranj Slovenia 
Pages
343-354
Publication year
2024
Publication date
2024
Publisher
De Gruyter Poland
ISSN
13300075
e-ISSN
18469558
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3062068407
Copyright
© 2024. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.