게시판
| 21KS-007 |
Microbiological and Physicochemical Stability of opioids and antiemetics for IV-PCA: An In Vitro Study
고려대학교 구로병원 의과대학 마취통증의학교실
Background: Postoperative patient-controlled analgesia provides pain relief, encourages early mobilization, and results in a shortened hospital stay. Patient-controlled analgesia involves the mixing of different types of drugs. When using patient-controlled analgesia, it is important to confirm the microbiological and physicochemical stability of each drug in a mixture to guarantee that the drug is delivered to the patient in an unaltered form.
Objectives: To confirm the microbiological and physicochemical stability of various drug mixtures for intravascular patient-controlled analgesia.
Study Design: An in vitro protocol to examine the microbiological and physicochemical stability of the most commonly used postoperative intravascular patient-controlled analgesia mixtures at our institution.
Setting: In vitro laboratory study
Methods: Each mixture contained a total of four drugs: fentanyl 400 hone 4 mg or oxycodone 10 mg, and either ramosetron 0.3 mg or ondansetron 10 mg. Each mixture was placed in a portable patient-controlled analgesia system containing 0.9% saline and stored at a constant temperature of 24°C for 96 h. Physical properties (color, transparency, and sedimentation) were observed with the naked eye and optical microscopy. Sterility testing was performed to assess microbiological contamination in the drug mixture during the 96-h study period. The pH of each mixture was evaluated for up to 96 h after mixing. The concentration of each drug was evaluated by high-performance liquid chromatography every 24 h until 96 h after mixing.
Results: All mixtures appeared visibly transparent, and no sediments were visible under the microscope. Bacterial or fungal growth was not observed in any of the samples after 14 days of incubation. The pH variations in all mixtures were maintained within 0.25 over the 96-h study period. The concentration of drugs, except ketorolac, ranged from 90up to 96 h after mixing. In the mixtures with a pH of 4.21gnificantly decreased at 24 and 48 h.
Limitations: Confirmation of the stability of drugs in vitro does not automatically ensure that the pharmacokinetics and pharmacodynamics of the drugs are not altered in vivo.
Conclusion: With the exception of ketorolac, the drugs used in the intravascular patient-controlled analgesia drug mixtures in this study were physicochemically stable up to 96 h after mixing. The concentration of ketorolac decreased in more acidic mixtures.
References
1.Grass JA. Patient-controlled analgesia. Anesth Analg 2005; 101:S44-S61.
2.Joshi GP. Multimodal analgesia techniques and postoperative rehabilitation. Anesthesiol Clin North Am 2005; 23:185-202.
Objectives: To confirm the microbiological and physicochemical stability of various drug mixtures for intravascular patient-controlled analgesia.
Study Design: An in vitro protocol to examine the microbiological and physicochemical stability of the most commonly used postoperative intravascular patient-controlled analgesia mixtures at our institution.
Setting: In vitro laboratory study
Methods: Each mixture contained a total of four drugs: fentanyl 400 hone 4 mg or oxycodone 10 mg, and either ramosetron 0.3 mg or ondansetron 10 mg. Each mixture was placed in a portable patient-controlled analgesia system containing 0.9% saline and stored at a constant temperature of 24°C for 96 h. Physical properties (color, transparency, and sedimentation) were observed with the naked eye and optical microscopy. Sterility testing was performed to assess microbiological contamination in the drug mixture during the 96-h study period. The pH of each mixture was evaluated for up to 96 h after mixing. The concentration of each drug was evaluated by high-performance liquid chromatography every 24 h until 96 h after mixing.
Results: All mixtures appeared visibly transparent, and no sediments were visible under the microscope. Bacterial or fungal growth was not observed in any of the samples after 14 days of incubation. The pH variations in all mixtures were maintained within 0.25 over the 96-h study period. The concentration of drugs, except ketorolac, ranged from 90up to 96 h after mixing. In the mixtures with a pH of 4.21gnificantly decreased at 24 and 48 h.
Limitations: Confirmation of the stability of drugs in vitro does not automatically ensure that the pharmacokinetics and pharmacodynamics of the drugs are not altered in vivo.
Conclusion: With the exception of ketorolac, the drugs used in the intravascular patient-controlled analgesia drug mixtures in this study were physicochemically stable up to 96 h after mixing. The concentration of ketorolac decreased in more acidic mixtures.
References
1.Grass JA. Patient-controlled analgesia. Anesth Analg 2005; 101:S44-S61.
2.Joshi GP. Multimodal analgesia techniques and postoperative rehabilitation. Anesthesiol Clin North Am 2005; 23:185-202.
