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Acta Poloniae Pharmaceutica ñ Drug Research, Vol. 68 No. 4 pp.

473ñ479, 2011 ISSN 0001-6837


Polish Pharmaceutical Society

HPLC-UV DETERMINATION OF MORPHINE IN HUMAN PLASMA AND ITS


APPLICATION TO THE CLINICAL STUDY

DANUTA SZKUTNIK-FIEDLER1*, EDMUND GRZEåKOWIAK1, MICHA£ GACA2,


and MAGDALENA BOROWICZ1

1
Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, 14 åw. Marii
Magdaleny St., 61-861 PoznaÒ, Poland
2
Clinics of Obstetrical and Gynecological Anaesthesiology, Poznan University of Medical Sciences,
33 Polna St., 60-535 PoznaÒ, Poland

Abstract: A sensitive and specific high-performance liquid chromatography method with ultraviolet detection
(HPLC-UV) has been developed for the quantification of morphine sulfate [(5α,6α)-7,8-didehydro-4,5-epoxy-
17-methylmorphinan-3,6-diol], (CAS: 52-26-6) in human plasma. The analyte was extracted from plasma sam-
ples with chloroform ñ isopropyl alcohol (90:10, v/v) and analyzed on a Bondapak C18 column. The calibration
curves were linear within the range of 10ñ150 ng/mL. The lower limit of quantitation was 10 ng/mL with 0.5
mL plasma sample. The mean recovery of the drug from plasma samples was 83.39%. The results from analy-
sis of quality-control samples at concentrations of 30, 75, and 150 ng/mL were indicative of good accuracy and
precision. This method was successfully used to analyze morphine in plasma samples of patients after abdom-
inal hysterectomy.

Keywords: high performance liquid chromatography, UV detector, plasma samples, morphine, hysterectomy,
pain

Morphine [(5α,6α)-7,8-didehydro-4,5-epoxy- Many different chromatographic assays for the


17-methylmorphinan-3,6-diol] (Fig. 1) is a phen- determination of morphine in biological fluids can
antrene opioid receptor agonist and its main effect is be found in the literature (1ñ40).
binding to and activating the µ-opioid receptors in It is a well-known fact that morphine measure-
the central nervous system. Morphine is also a κ-opi- ments can be best performed by using mass spec-
oid and δ-opioid receptor agonist, κ-opioidís action trometry (HPLC-MS) (2ñ12), tandem mass spec-
is associated with spinal analgesia, miosis (pinpoint trometry (HPLC-MS/MS) (11ñ24) and GC-MS (4,
pupils) and psychomimetic effects, whereas δ-opioid 25ñ27) detection. In many cases these techniques
is believed to play a role in analgesia. Morphine is have achieved both the desired sensitivity and fast
the most frequently used as an analgesic drug for run time, which is important in drug analysis.
both postoperative and cancer pain (1). Unfortunately, these combinations are very expen-
sive and therefore not routinely used for monitoring
of morphine in laboratories.
Chromatographic procedures, described previ-
ously, were based also on fluorescence (1, 4, 10,
28ñ30), electrochemical (ECD) (10, 31ñ37) or diode
array (DAD) detection (10, 38ñ40).
The combined ECD detection with UV was
also described by some authors (4, 10).
Opiate analgesics may also be monitored by
immunoassay or radioimmunoassay (RIA), which
are very sensitive tests, but cross-reactions of ana-
lytes with the antisera complicate very often the
Figure 1. Chemical structure of morphine assay and provide false results (10).

* Corresponding author: e-mail: d.szkutnik@wp.pl; phone: +48 61 6687853; fax: +48 61 6687858

473
474 DANUTA SZKUTNIK-FIEDLER et al.

Figure 2. UV spectrum of morphine (Photodiode Array Detector, Waters 474)

A B
Figure 3. Chromatograms of morphine in human plasma. (A) plasma sample at 1 h after i.v. administration of morphine in patient no. 5
(retention time of morphine 5.037 min). (B) Blank plasma

Capillary zone electrophoresis (CZE) does not offers an alternative to the previously described pro-
have sufficient sensitivity for pharmacokinetic stud- cedures available for pharmacokinetic and monitor-
ies (10). ing studies of morphine.
For these reasons, high performance liquid Using this HPLC-UV assay, plasma concentra-
chromatography is the most popular choice for the tions of morphine in patients after hysterectomy
determination of morphine and its metabolites in were analyzed.
biological fluids (4, 10).
In the present study, a sensitive and inexpen- MATERIALS AND METHODS
sive HPLC-UV assay for the determination of mor-
phine in human plasma is described. During devel- Materials
opment of a modified HPLC method with fluores- Morphine sulfate, CAS: 52-26-6 (pure for
cence detection, adequate parameters for the extrac- analysis) was obtained from Sigma-Aldrich
tion and UV detection of morphine were found. It (Steinheim, Germany). Morphine sulfate ñ solution
HPLC-UV determination of morphine in human plasma and its application... 475

for injections, 20 mg/mL, batch no: 05BDO107 was HPLC analysis


supplied by Polfa Warszawa, Poland. Acetonitrile, First of all, in order to find optimum wave-
n-hexane, methanol (HPLC grade) and sodium length for ultraviolet detection of morphine, the UV
hydroxide (analytical grade, pure for analysis) were spectrum of this drug was determined (Fig. 2).
purchased from Merck (Darmstadt, Germany). All Using Photodiode Array Detector (Waters 474) the
other chemicals (chloroform, isopropyl alcohol, eth- wavelength of morphine was set at 226 nm.
ylene diamine tetraacetic acid sodium salt, boric This method was based on the HPLC methods
acid, sodium borate, monopotassium phosphate, with fluorescence detection (1, 10, 29, 30).
hydrochloric acid ) were of analytical reagent grade The HPLC system was constructed from the
(Merck, Germany). Human plasma was obtained following components: HPLC Waters 2695
from the Laboratory of the Blood Donation Centre Separations Module with autosampler, Waters 2487
(PoznaÒ, Poland). Dual l Absorbance Detector. Analytes were separat-
ed by an analytical column Bondapak C18 (150 mm
Standard solutions ◊ 4 mm, 10 µm) from Waters. Temperature of col-
Standard stock solutions of morphine sulfate umn was maintained at 25OC. Total analysis time
were prepared by dissolving accurately weighed was 7 min and the flow rate was set at 0.8 mL/min.
substances (100 mg) in bidistilled water (100 mL) to Samples were eluted with a mobile phase: acetoni-
obtain final concentration of 1 mg/mL. Stock solu- trile : bidistilled water : methanol (60:840:100,
tions were stored at 4OC and remained stable for at v/v/v) with addition of 0.012 M monopotassium
least 1 month. phosphate, and 0.5 mM ethylenediaminetetraacetic
Working solutions (used with the purpose of acid disodium salt.
validation and calibration) were prepared ex tempore Data collection and processing was carried out
by further dilution of stock solution with bidistilled by Empower Pro software.
water to provide final concentrations of 10, 20, 30,
50, 75, 100, and 150 ng/mL for morphine sulfate in Clinical study
plasma. Consent for the study
For preparing calibration curves, a volume of The study was approved by the Ethics
10 mL of an adequate working solutions were Committee at the Poznan University of Medical
spiked to 0.5 mL of blank heparinized plasma, and Sciences. A day before the surgery, patients
then extracted, according to procedure described received written information with a consent for par-
below. ticipation in the studies.

Extraction of morphine sulfate from plasma sam- Characterization of the investigated population
ples: Subjected were 15 patients (women, 54.3 ± 4.6
To 0.5 mL of plasma sample with morphine, years of age, weight 64.5 ± 9.4 kg) after hysterecto-
0.5 mL of borate buffer solution (pH 8.9) and 6 mL my, whom applied intravenous bolus (i.v.) of mor-
of chloroform ñ isopropyl alcohol solution (90:10, phine (Morphini sulfas ñ solution for injections, 20
v/v) were added. The mixture was vortexed for 20 mg/mL) with dose titration to achieve the effective
min and centrifuged (2000 ◊ g, 10 min). The organ- morphine dose (2 mg of morphine given every 2ñ3
ic layer was transfered to another tube, to which 2 min, until the pain was eliminated or lessened ñ VAS
mL of 5 mM ammonium phosphate buffer pH 9.3 < 4), then constant infusion was maintained after cal-
was added and the mixture was vortexed for 1 min culating the infusion rate based on the biological
and centrifuged (2000 ◊ g, 5 min). The supernatant morphine half-life (t0.5 = 3 h); breakthrough pains
was discarded and the organic layer containing mor- were treated with administration of an additional
phine was transfered into a glass vial, 150 mL of 0,1 bolus dose of 2 mg i.v. After the surgery, the patients
M hydrochloric acid was added and the mixture was additionally received 100 mg of ketoprofen (Ketonal
vortexed for 2 min and centrifuged (2000 ◊ g, 5 ñ solution for injections, 100 mg/2 mL, i.v.).
min). The separated acid layer was transferred to Patients were qualified to ASA risk groups I (n
another glass tube, 15 mL of 1 M sodium hydroxide = 12) and II (n = 3), without history of liver and kid-
and 1 mL of hexane were added and the mixture was ney diseases, with normal laboratory results, accord-
vortexed for 20 s and centrifuged (1500 ◊ g, 2 min). ing to standards of premedication care, not taking
The organic layer was transfered to 1.5 mL analgesics on a chronic basis and without con-
polypropylene Eppendorf tube and 50 µL was traindications to morphine analgesia. Surgeries were
injected into the chromatographic system. carried out under general anesthesia with intratra-
476 DANUTA SZKUTNIK-FIEDLER et al.

cheal intubation, after induction with propofol, mus- injection was about 7 min. There were no interfering
cle relaxation with rocuronium. peaks in the blank plasma at the retention time of
morphine. No carry-over (memory effect) problem
Course of the study was observed in this assay as 50 µL of mobile phase
The patients had 5 mL of venous blood sam- was injected into the HPLC system after analyzing
pled 7 times, from a peripheral vein, in aseptic con- plasma samples containing morphine.
ditions; the first sample to exclude the patientís tak-
ing morphine, second ñ after the surgery, but before Linearity
administration of morphine ñ sample 0, with subse- Calibration curves (n = 6) were prepared by
quent samples 1, 2, 4, 8 and 12 h after administration spiking 10 µL of the appropriate working solution to
of morphine. Blood was sampled to syringes, trans- 0.5 mL of blank human plasma. Final concentrations
ferred to test tubes with lithium heparin, and then of morphine in plasma samples were: 10, 20, 30, 50,
centrifuged at temperature of 20OC for 10 min and 75, 100 and 150 ng/mL. Three spiked plasma sam-
frozen at temperature of ñ70OC. These samples were ples were analyzed at each concentration level.
used for determination of plasma concentrations of Calibration curves for the plasma assay developed
morphine (HPLC-UV). with peak area of morphine (y) versus drug concen-
The patients were monitored for 12 h after the tration (x) were found to be linear in the examined
surgery. Pain intensity was evaluated according to a concentration range.
VAS scale before administration of morphine, and 1, Coefficient of variation (CV) for slope (a =
2, 4, 8 and 12 h after administration. During this peri- 274.04 ± 25.76; n = 6) and intercept (b = 82.17 ±
od, arterial blood pressure, heart rate, diuresis, SpO2 13.24; n = 6) were 9.4 and ñ16.11%, respectively.
and breath rate per minute were monitored. Depth of Assay linearity in the range of the morphine con-
sedation was also estimated with an Aldrete scoring. centrations to be expected was concluded from the
All cases of undesirable effects were recorded. mean correlation coefficient of r = 0.994 ± 0.003 (n
= 6); CV was 0.34%.
RESULTS
Recovery
The HPLC method was validated in accor- The recovery of morphine was assessed by
dance with the published guidelines (41, 42). comparing the response of five replicates of extract-
Specificity ed QC samples (30, 75 and 150 ng/mL) to the
The specificity of the method was examined by response of the pure standard at the same concentra-
comparing the chromatogram of the drug-free plas- tion level.
ma sample with that of the plasma sample spiked The standard specimens were dissolved in
with morphine. Representative chromatograms of water assigned for injection and injected directly
morphine are shown in Fig. 3. into the HPLC chromatograph. The recovery of
Retention time of morphine was approximate- morphine was greater than 90% for all tested con-
ly 5.037 min. The total run time for each sample centrations. The results are shown in Table 1.

Table 1. Results of intra-day and inter-day validation of morphine in human plasma.

Concentration Concentration
added founded SD CV (%) Bias (%) Recovery (%) n
(ng/mL) (ng/mL)
Intra-day
30 31.02 3.31 10.66 3.40 110.13 5
75 75.47 2.17 2.88 0.63 100.10 5
150 148.12 9.25 6.24 -1.20 103.78 5
Inter-day
30 28.81 3.04 10.57 -3.97 98.62 15
75 74.18 2.09 0.03 -1.09 92.20 15
150 153.78 10.36 6.74 2.50 96.43 15
SD = standard deviation; CV = coefficient of variation
HPLC-UV determination of morphine in human plasma and its application... 477

Figure 4. The mean plasma concentration vs. time profiles of morphine in women after hysterectomy (n = 15, i.v. administration of mor-
phine)

Table 2. Stability of morphine in human plasma samples.

Short-term stability (48 h)


in an autosampler
Concentration of
30 75 150
morphine (ng/mL)
Mean 33.04 75.08 159.96
SD 0.61 1.13 2.67
CV (%) 1.84 1.50 1.67
Long-term stability (30 days)
Concentration of
30 75 150
morphine (ng/mL)
Mean 31.67 76.18 148.12
SD 1.45 3.63 5.89
CV (%) 4.58 4.76 3.98
Long-term freezer stability ñ freeze-thaw
stability after three cycles
(ñ80OC, 30 days)
Concentration of
30 75 150
morphine (ng/mL)
% of the initial conc. of
98.20 95.15 97.45
morphine after 30 days
SD 2.14 1.58 2.34
CV (%) 0.02 0.02 0.02

Precision and accuracy The intra- and inter-day precision was


Blank plasma samples were spiked with mor- expressed as the coefficient of variation value: CV =
phine at three concentration levels QC (30, 75 and [SD/C] ◊ 100%, where: SD is the standard deviation
150 ng/mL). The intra-day accuracy and precision of the mean concentration of morphine and C is the
were determined using five replicates of QC sam- mean concentration of morphine (Tab. 1).
ples on the same day; the inter-day accuracy and The accuracy (bias) for morphine was
precision were determined by analyzing three cali- expressed as the percentage deviation of observed
bration curves with five replicates of QC samples on concentration from theoretical concentration.
three separate days.
478 DANUTA SZKUTNIK-FIEDLER et al.

Bias = [(found concentration ñ added concentra- pressure, pulse value, breathing frequency and seda-
tion)/added concentration] ◊ 100% (Tab. 1). tion level were not significantly different from val-
ues of these parameters before the morphine was
Limits of quantitation and detection applied.
The limit of quantitation (LOQ) of morphine,
defined as the lowest concentration that could be DISCUSSION
measured with accuracy and precision, i.e., within
±20% of the actual value, was 10 ng/mL. A specific and sensitive HPLC-UV method for
The lowest amount of morphine in the sample, measurement of morphine plasma concentrations
which can be detected but not necessarily quantitat- was described. This method is in accordance with
ed under stated experimental conditions (detection guidelines for validation of analytical methods
limit, LOD), was based on SD of response and employed in bioavailability and pharmacokinetic
slope: LOD = 3.3δ/S, where S is the slope of the cal- studies in men and animals (41, 42).
ibration curve and δ is SD of blank response (34). The chromatograms of morphine, obtained
LOD of morphine in this method was 5.23 under this assay conditions, were sharp and sym-
ng/mL. metrical; total run time was less than 7 min (Fig. 3).
The sample volume required is only 0.5 mL, com-
Stability pared with 1.0ñ2.0 mL for other methods (4, 10).
Short-term stability of plasma samples was Extraction recoveries for morphine were consistent,
examined by supplementing blank plasma with precise and reproducible throughout the validation
appropriate amounts of working solutions of mor- experiments and were within the acceptance criteria.
phine to yield quality-control (QC) samples contain- The intra- and inter-run precision was less than 11%,
ing 30, 75, and 150 ng/mL. Each sample was ana- and the accuracy was within ±3.97% (Tab. 1), which
lyzed at room temperature for 48 h (every 4 h), proves the acceptable accuracy and precision of the
including their residence time in an autosampler. CV method developed.
values were: 1.84, 1.50 and 1.67% for morphine con- Stability experiments showed that no signifi-
centrations of 30, 75 and 150 ng/mL, respectively. cant degradation occurred at ambient temperature
Long-term stability of plasma samples at room for 40 h, 30 days and during the three freeze-thaw
temperature was assessed for 30 days. The concen- cycles for morphine plasma samples. The small
tration of the stability QC samples (30, 75, and 150 mean CV values for 30, 75 and 150 ng/mL indicat-
ng/mL) were compared to the mean of back-calcu- ed analyte stability.
lated values for the standards at the appropriate con- Standard solutions of morphine prepared in bidis-
centration from the first day of long term stability tilled water were stable for at least 1 month at 4OC.
testing. CV values for analyzed QC samples: 30, 75, The reagents used in the method are inexpen-
and 150 ng/mL were 4.58, 4.76 and 3.98%, respec- sive and readily available and the procedure does
tively. not involve any critical experimental conditions.
To determine long-term freezer stability of This HPLC method may be suitable for quantifica-
morphine in plasma, QC samples (30, 75, and 150 tion of morphine sulfate in small samples of plasma.
ng/mL) were analyzed in triplicate after storage at The fact, that our assay of morphine is less sensitive
ñ 80OC for 1, 2, and 30 days. The drug was regarded than that using, for example, mass spectrometry
as stable if more than 90% was intact at the end of detection is evident. However, HPLC-MS or HPLC-
the study period. The amount of the initial concen- MS-MS for quantification of morphine is far more
tration of morphine remaining after this time was: expensive than the HPLC-UV method.
98.20 ± 2.14%, 95.15 ± 1.58% and 97.45 ± 2.34% Detection limit of the assay is sufficient for
for 30, 75 and 150 ng/mL, respectively. drug monitoring in optimizing of postoperative
The results of stability of morphine plasma analgesia. The procedure is sensitive and selective
samples are presented in Table 2. as well as suitable for determining the pharmacoki-
netics of morphine in clinical studies. It offers a suit-
Clinical study able alternative to existing HPLC techniques.
The mean plasma concentration versus time profiles
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Received: 22. 07. 2010

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