Stability of an epidural analgesic solution containing adrenaline, bupivacaine and fentanyl

Kjønniksen, Inge; Brustugun, Jørgen; Niemi, Geir; Breivik, Harald; Anderssen, E.; Klem, W.

doi:10.1034/j.1399-6576.2000.440713.x

Cited by 24 publications

(15 citation statements)

References 5 publications

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“…We also found a smaller fall in epinephrine concentration (7.4% loss) and pH (4.31-4.18) at room temperature over 180 days, with no visible discoloration of the solution, perhaps due to the lower concentrations of epinephrine used in this study. Our findings are in accordance with those of Kjonniksen and coworkers [8], who studied the stability of the solution described by Niemi and Breivik [2], i.e. fentanyl (2 lg.ml )1 ), bupivacaine (1 mg.ml )1 ) in PVC bags and epinephrine (2 lg.ml )1 ) stored at 2-8°C for 180 days and then 22°C for a further 4 days.…”

Section: Discussionsupporting

confidence: 92%

“…For this to occur, stability data for the admixture are required. While stability data have been published for solutions containing epinephrine with fentanyl and bupivacaine from around the world [7][8][9], for a number of reasons these data are not transferable to UK practice, as described below. We therefore undertook this study to determine whether an admixture containing epinephrine (2 lg.ml )1 ), fentanyl (2 lg.ml )1 ) and bupivacaine (1 mg.ml )1 ) was stable using agents readily available to UK hospital pharmacies.…”

Section: Discussionmentioning

confidence: 99%

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Stability of an epidural analgesic admixture containing epinephrine, fentanyl and bupivacaine

Priston¹,

Hughes²,

Santillo³

et al. 2004

Anaesthesia

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SummaryThe addition of epinephrine to solutions containing fentanyl and bupivacaine for epidural infusion has been shown to improve the quality of analgesia. However, this admixture is not available commercially in the United Kingdom. Moreover, stability data applicable to UK practice for this admixture are limited. This study investigated the stability of fentanyl 2 lg.mlplus bupivacaine 1 mg.ml )1 in PVC bags with and without epinephrine 2 lg.ml )1 over a period of 184 days both at room temperature and at 4°C. All infusions were found to be stable over the study period (> 90% remaining) using stability-indicating High Performance Liquid Chromatography (HPLC) methods, with no changes in physical appearance or pH (range 4.5-4.2). The infusions were prepared using standard pharmaceutical products, so facilitating the batch preparation of epinephrine, fentanyl and bupivacaine epidural solutions by hospital pharmacy departments.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Stability of an epidural analgesic admixture containing epinephrine, fentanyl and bupivacaine

Priston¹,

Hughes²,

Santillo³

et al. 2004

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…The HPLC methods were based on previously published methods, which were modified and their ability to monitor stability was evaluated during validation studies. Briefly, an Agilent Technologies 1100 HPLC system (Agilent Technologies Inc., Waldbronn, Karlsruhe, Germany) employing a binary pump, micro‐vacuum degasser, autosampler, thermostatted column compartment, diode array detector, fluorescent detector and Agilent Technologies Chemstation ® for LC 3D Software (Rev.…”

Section: Methodsmentioning

confidence: 99%

Stability of an epidural analgesic admixture of levobupivacaine, fentanyl and epinephrine

et al. 2013

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“…Optimal separation of fentanyl citrate and bupivacaine hydrochloride is possible at 15%–40% concentration of the organic component in the mobile phase. It is suggested that the inorganic component should have pH ≤ 5 8–13. UV detection at λ=210 nm was selected as it is the absorbance maximum for fentanyl citrate present in the solution at a concentration 200 times lower than that of bupivacaine hydrochloride, which poses a considerable analytical problem.…”

Section: Resultsmentioning

confidence: 99%

Development and validation of an HPLC method to determine the stability of fentanyl citrate and bupivacaine hydrochloride mixtures in infusion solutions

2012

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BackgroundThe use of a combination of different drugs in postoperative analgesia extends the time of analgesia, makes it more efficient and allows the use of lower drug doses, which leads to less risk of side effects and drug dependence. The aim of this study was to develop and validate an HPLC method to determine the stability of fentanyl citrate and bupivacaine hydrochloride mixtures in standard infusion solutions of 0.9% sodium chloride and 5% glucose.MethodsAfter optimisation, the HPLC method parameters were as follows: LiChrospher 100 CN, 250×4 mm (10 µm) column; mobile phase: mixture of acetonitrile and phosphate buffer at pH 2.8 (3:7, V/V) with addition of 0.08 g/l potassium chloride; flow rate: 1.5 ml/min; column temperature: 30°C; spectrophotometric detection at 210 nm. Development of the method involved checking the impact of acetonitrile and KCl concentrations in the mobile phase and choosing the internal standard. Method validation included determining the specificity of the method, its accuracy, linearity, precision, repeatability, limits of detection and quantification.ResultsThe retention times of bupivacaine hydrochloride, fentanyl citrate and procaine hydrochloride, used as an internal standard, were approximately 10 min, 15 min and 5 min, respectively. Method validation confirmed its selectivity, accuracy and precision. The average values of the variation and accuracy coefficients were 0.70% and 99.02% for bupivacaine hydrochloride, and 1.76% and 104.53% for fentanyl citrate. The intermediate precision values were 1.25% for bupivacaine hydrochloride and 1.52% for fentanyl citrate.

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Stability of an epidural analgesic solution containing adrenaline, bupivacaine and fentanyl

Abstract: The triple-component epidural analgesic solution remained stable during six months of cold storage, followed by four days of storage at room temperature. No significant degradation of adrenaline was observed in infusion solutions returned from the wards.

Cited by 24 publications

References 5 publications

Stability of an epidural analgesic admixture containing epinephrine, fentanyl and bupivacaine

Stability of an epidural analgesic admixture containing epinephrine, fentanyl and bupivacaine

Stability of an epidural analgesic admixture of levobupivacaine, fentanyl and epinephrine

Development and validation of an HPLC method to determine the stability of fentanyl citrate and bupivacaine hydrochloride mixtures in infusion solutions

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