Drug mixtures and infusion technology

Abstract

We enjoyed the recent editorial by Nestor et al. [1] and were particularly struck by the comment that "the use of off-label or unlicensed drugs. . .is rife in our specialty." This comment reflects the high incidence of the practice of mixing remifentanil with propofol, especially in paediatric practice by 38% of survey respondents [2], although this survey has not been without criticism. The same editorial argues that "safety is usually only regarded as proven once a drug or

Drug mixtures and infusion technology: replies

“…In paediatrics, where the margin of error is even smaller, this is a significant limitation, in our opinion. Lyons et al refer to other 'unlicensed' drug mixtures used within anaesthesia to justify this practicelidocaine with propofol, cefuroxime with metronidazole and dexamethasone with ondansetron [8]. Unlike mixing propofol with an opioid, the product characteristics of these medications support compatibility and use once certain requirements are met [9].…”