Microbial growth in a mixture of hyperbaric bupivacaine and fentanyl prepared in a multi-dose syringe in the operating theatre environment

Morgan, G. L.

doi:10.1080/22201173.2010.10872661

Cited by 2 publications

(3 citation statements)

References 60 publications

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“…Fentanyl citrate has displayed evident inhibitory potency on the pathogens except Klebsiella pneumoniae, nevertheless our predefined minimum concentration inhibited growth by 9.5 %. To our knowledge there are few studies focused on fentanyl's antimicrobial properties and some of them oppose to our results [12]. For instance; Rota et al [13] were not able to demonstrate inhibiting effect of fentanyl.…”

Section: Discussioncontrasting

confidence: 82%

“…However, fentanyl is a physicochemically stable drug and can be stored in the syringe up to 1 week as a mixture with other drugs such as midazolam under 32 °C [ 16 ]. Refilling of the syringes with this drug does not cause microbial contamination as observed in one prospective longitudinal study [ 12 ]. The reliability of multi-dosing with the same syringe is often questioned by the clinicians and considering our results this approach seems adequate.…”

Section: Discussionmentioning

confidence: 96%

“…Fentanyl citrate ampoules contain 500 g/10 ml which is a large dose for one-use only. Therefore, multi-dosing with the same syringe is a quite common application practice in the ICU settings [12][13][14][15]. It could be argued that the drug would degrade and become susceptible to contamination during the time kept at room temperature in the same syringe.…”

Section: Discussionmentioning

confidence: 99%

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Investigating antimicrobial features and drug interactions of sedoanalgesics in intensive care unit: an experimental study

et al. 2021

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Study Objective: Aim of this study was to evaluate antimicrobial effects and interaction between analgesic combinations of fentanyl citrate, dexmedetomidine hydrochloride and tramadol hydrochloride on Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Candida albicans which are some of the most common nosocomial infection related microorganisms. Design: In vitro prospective study. Setting: University Clinical Microbiology Laboratory. Measurements: In order to evaluate in vitro antimicrobial effects and interaction between analgesic combinations, tramadol hydrochloride, fentanyl citrate and dexmedetomidin were used against S. aureus ATCC 29213, K. pneumoniae, E. coli ATCC 25922, P. aeruginosa ATCC 27853 and C. albicans ATCC 10231 standard strains by microdilution method. Main Results: According to microdilution assays tramadol has shown the most efficient antimicrobial activity also it has been observed that 10 mg/ml concentrated dexmedetomidine has antimicrobial effects on S. aureus, K. pneumoniae and P. aeruginosa. Fentanyl has displayed evident inhibitory potency on the pathogens except for Klebsiella pneumoniae, nevertheless our predefined minimum concentration inhibited growth by 9.5 %. Fentanyl and dexmedetomidine together exhibited more antimicrobial effect on P. aeruginosa and E. coli growth. Additionally, when the three drugs examined together, microbial inhibition occurred more than expected on E. coli again and also on C. albicans growth. Conclusions: Our results revealed the antimicrobial properties and synergy with the different combinations of fentanyl, dexmedetomidine and tramadol against the most common nosocomial infection agents in the ICU. This is the first study in the literature looking into the microbial “interactions” of opioids and sedative drugs but more research is needed in order to define clinico-laboratory correlation. ©2021 by the authors. This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Investigating antimicrobial features and drug interactions of sedoanalgesics in intensive care unit: an experimental study

et al. 2021

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Microbial contamination and labelling of self-prepared, multi-dose phenylephrine solutions used at a teaching hospital

Heever

Scribante

Perrie

et al. 2016

Southern African Journal of Anaesthesia and Analgesia

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Background: Common practice at Chris Hani Baragwanath Academic Hospital (CHBAH) is to use boluses from a self-prepared, multi-dose phenylephrine solution to treat spinal anaesthesia-induced hypotension in patients undergoing a Caesarean section. The aims of this study were to determine if there was microbial contamination of the solutions and to evaluate whether healthcare workers adhered to appropriate labelling and aspiration practices. Methods: A sample was collected and the labelling data were documented from the solutions found in the two obstetric theatres at CHBAH over a three-month period. The samples were sent to a laboratory for microbial investigation. Results: Microbial contamination was identified in 6.4% of samples collected. The name of the solution was indicated on 100% of the containers and the concentration of the solution was on 96.4%. The date the solution was prepared was indicated on 74.6% of containers and the time the solution was prepared was on 57.3%. Only 8.2% of healthcare workers who prepared the solution confirmed it by placing a signature on the container. Labelling data were written directly on 100% of the containers and a spikedevice was used in 64.5% of the containers. Conclusions: This study demonstrated microbial contamination of the solution and may indicate an infection hazard. Healthcare workers also did not adhere to appropriate labelling and aspiration practices. This is important for all patients from a patient safety perspective and the need to improve quality of care.

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Microbial growth in a mixture of hyperbaric bupivacaine and fentanyl prepared in a multi-dose syringe in the operating theatre environment

Cited by 2 publications

References 60 publications

Investigating antimicrobial features and drug interactions of sedoanalgesics in intensive care unit: an experimental study

Investigating antimicrobial features and drug interactions of sedoanalgesics in intensive care unit: an experimental study

Microbial contamination and labelling of self-prepared, multi-dose phenylephrine solutions used at a teaching hospital

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