Compatibility of ketamine and morphine injections

Lau, Min-Hui; Hackman, C.; Morgan, Denis J.

doi:10.1016/s0304-3959(97)00176-0

Cited by 18 publications

(2 citation statements)

References 5 publications

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“…As for ketamine hydrochloride, the stability and compatibility test of ketamine hydrochloride combined with other drugs in infusion solutions has been widely demonstrated that ketamine hydrochloride is a highly stable drug. It has been reported to be stable with tramadol hydrochloride,25 morphine hydrochloride,26–29 hydromorphone,30,31 fentanyl citrate,32 dexamethasone sodium phosphate,33 clonidine hydrochloride,34 midazolam hydrochloride,34 lormetazepam,34 and propofol35 in binary admixtures. Regarding droperidol, the solubility showed strong pH dependence (pKa was 7.64), which is stable in acid solution and may cause drug precipitation or crystallization in alkaline solution.…”

Section: Discussionmentioning

confidence: 99%

Physicochemical stability of ternary admixtures of butorphanol, ketamine, and droperidol in polyolefin bags for patient-controlled analgesia use

Fang

Wang²,

et al. 2016

DDDT

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BackgroundDelivery of drug admixtures by intravenous patient-controlled analgesia is a common practice for the management of postoperative pain; however, analytical confirmation of the compatibility and stability of butorphanol tartrate, ketamine hydrochloride, and droperidol combined in ternary admixtures is not available.MethodsButorphanol tartrate, ketamine hydrochloride, and droperidol have been examined for compatibility and stability when combined with 0.9% sodium chloride injection stored at 4°C and 25°C with light protection for a total of 14 days. Concentrations were 0.067 mg/mL, 1.33 mg/mL, and 0.033 mg/mL for butorphanol tartrate, ketamine hydrochloride, and droperidol, respectively. Drug concentrations were determined using high-performance liquid chromatographic analysis.ResultsAll three drugs were very stable (>97%) at 4°C and 25°C for 14 days. The ternary admixtures were initially clear and colorless throughout the observation period, and the pH value did not change significantly.ConclusionThe results confirm that the ternary admixture of butorphanol tartrate 0.067 mg/mL, ketamine hydrochloride 1.33 mg/mL, and droperidol 0.033 mg/mL in 0.9% sodium chloride injection were stable for 14 days when stored in polyolefin bags at 4°C and 25°C and protected from light.

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Section: Discussionmentioning

confidence: 99%

Physicochemical stability of ternary admixtures of butorphanol, ketamine, and droperidol in polyolefin bags for patient-controlled analgesia use

Fang

Wang²,

et al. 2016

DDDT

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“…Ketamine hydrochloride was found to be compatible when diluted with water or 0.9% sodium chloride injection, packaging in glass vials, or polypropylene syringes at room temperature [ 34 – 36 ]. The compatibility and stability studies also reported that most of the tested drugs, such as morphine [ 37 – 40 ], hydromorphone [ 41 , 42 ], fentanyl citrate [ 43 ], and dexamethasone sodium phosphate [ 44 ], were stable and compatible in the presence of ketamine hydrochloride. Unfortunately, no published information is available on the compatibility and stability of butorphanol in combination with ketamine in PCA solution.…”

Section: Discussionmentioning

confidence: 99%

Butorphanol and Ketamine Combined in Infusion Solutions for Patient-Controlled Analgesia Administration: A Long-Term Stability Study

et al. 2015

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BackgroundKetamine in subanesthetic dose added to butorphanol has been reported to give superior pain control when used for intravenous patient-controlled analgesia (PCA) after surgery. However, this admixture is not available commercially and stability data applicable to hospital practice are limited.Material/MethodsThe butorphanol-ketamine admixtures were prepared in polyolefin bags and stored in the dark at 4°C, 25°C, or 37°C for 15 days. The initial concentrations were 50–150 microgram/ml for butorphanol and 1–4 mg/ml for ketamine, respectively. The stabilities were determined by visual inspection, pH measurement, and high-pressure liquid chromatography (HPLC) assay of drug concentrations.ResultsOver the 15 days, all solutions were clear in appearance, and no color change or precipitation was observed among the three temperatures. The percentages of initial concentration of each drug were over 95% during the study period, and the pH value did not change significantly.ConclusionsThe results indicate that the drug mixtures of butorphanol and ketamine in 0.9% sodium chloride injection were stable for 15 days when stored in polyolefin bags at 4°C, 25°C, or 37°C.

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Morphine and Ketamine Is Superior to Morphine Alone for Out-of-Hospital Trauma Analgesia: A Randomized Controlled Trial

Jennings

Cameron

Bernard

et al. 2012

Annals of Emergency Medicine

102

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Compatibility of ketamine and morphine injections

Abstract: The compatibility of ketamine and morphine mixture was studied. In addition, pH adjustment to minimise local tissue irritation led to no change in stability of the mixture up to pH 5.9. It appears that ketamine and morphine mixtures are stable over a 24 h period.

Cited by 18 publications

References 5 publications

Physicochemical stability of ternary admixtures of butorphanol, ketamine, and droperidol in polyolefin bags for patient-controlled analgesia use

Physicochemical stability of ternary admixtures of butorphanol, ketamine, and droperidol in polyolefin bags for patient-controlled analgesia use

Butorphanol and Ketamine Combined in Infusion Solutions for Patient-Controlled Analgesia Administration: A Long-Term Stability Study

Morphine and Ketamine Is Superior to Morphine Alone for Out-of-Hospital Trauma Analgesia: A Randomized Controlled Trial

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