The growth of bacteria in infusion drugs: propofol 2% supports growth when remifentanil and pantoprazole do not

Erden, İsmail; Gülmez, Dolunay; Pamuk, Almıla Gülsün; Akincia, Seda Banu; Hasçelik, Gülşen; Aypar, Ülkü

doi:10.1016/j.bjane.2012.10.003

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…10 Remifentanil, which is an analog of fentanyl, was also stated to decrease bacterial growth. 16,17 Tamai-Shacooriz et al in their investigation, reported that sufentanil increased the antibacterial activity of bupivacaine but not ropivacaine. 9 Antibacterial effect of lidocaine was shown in several investigations.…”

Section: Discussionmentioning

confidence: 98%

Growth of Microorganisms in Propofol and Mixture of Propofol, Lidocaine and Fentanyl

Altan

Bonabi

Kesi̇ci̇

et al. 2019

J Coll Physicians Surg Pak

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Section: Discussionmentioning

confidence: 98%

Growth of Microorganisms in Propofol and Mixture of Propofol, Lidocaine and Fentanyl

Altan

Bonabi

Kesi̇ci̇

et al. 2019

J Coll Physicians Surg Pak

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“…Plaques were incubated at 36 ± 2 °C for 24 h. Colony numbers (CFU.mL −1 ) were measured by a second researcher. 16 , 17 …”

Section: Methodsmentioning

confidence: 99%

The antimicrobial activity of ephedrine and admixture of ephedrine and propofol: an in vitro study

Tulgar

Alasehir

Selvi

2018

Brazilian Journal of Anesthesiology (English Edition)

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“…Previous studies have concluded that while simultaneous infusion removed the ability to selectively control the use of each drug, it resulted in decreased incidences of procedural respiratory depression and patient recovery time [18,19]. Furthermore, when mixed with propofol, remifentanil has been found to inhibit the bacterial growth that readily occurs within the lipid emulsion, possibly due to its glycine excipient and low pH [20,21].…”

Section: Introductionmentioning

confidence: 99%

“…For mixtures of remifentanil and propofol specifically, there are a lack of studies investigating a variety of remifentanil concentrations, the impact of mixing on both remifentanil and propofol concentration, and how manipulating solution pH (through the use of different remifentanil reconstitution mediums) affects the stability of the mixture. pH is of particular importance for a combination of remifentanil and propofol as remifentanil is believed to undergo rapid hydrolysis when exposed to a pH range of 7-7.5 [21]. After reconstitution with water, remifentanil has a pH of 3.0 [24].…”

Section: Introductionmentioning

confidence: 99%

The effect of concentration, reconstitution solution and pH on the stability of a remifentanil hydrochloride and propofol admixture for simultaneous co-infusion

Henkel

Vella

Behan³

et al. 2020

BMC Anesthesiol

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Background There are scenarios where pre-mixing and infusing analgesic and anaesthetic agents as a single intravenous (IV) solution is highly desirable; however, it is important to ensure the agents are compatible when mixed. As such, the long-term stability of a remifentanil-propofol mixture, and means of improving this, were assessed across a range of remifentanil concentrations, diluents, and time points. Methods Remifentanil was reconstituted with ultrapure water, 0.9% saline, 20% saline, or 8.4% sodium bicarbonate solution (the latter two chosen for their pH characteristics, rather than their use in pharmaceutical reconstitution) and then mixed with propofol (1%) or further diluted with water to derive concentrations of 10–50 μg mL− 1. Remifentanil and propofol concentrations were determined initially and then periodically for up to 24 h using high performance liquid chromatography (HPLC). Mass spectrometry (MS) was used to detect degradation products in solutions containing 30 μg mL− 1 of remifentanil. Statistical analysis was performed using ANOVA and Student’s t-test, with a significance value of 0.05. Results Isolated remifentanil (pH < 4) and propofol (pH 7.35) did not degrade significantly when reconstituted with water or saline solution over 24 h, while remifentanil reconstituted with sodium bicarbonate degraded significantly (P < 0.001, pH 8.65). Mixing with propofol substantially increased the pH of the mixture and resulted in significant remifentanil degradation for all reconstitution solutions used, while propofol remained stable (pH 6.50). The amount of degradation product detected in samples containing isolated remifentanil and a mixture of the drugs was proportional to the remifentanil degradation observed. Conclusions Remifentanil stability is affected by both the reconstitution solution used and when mixed with propofol, with pH appearing to be a contributing factor to degradation. If the pH of the solution and concentration of remifentanil are correctly controlled, e.g. through the use of a more acidic diluent, an admixture of remifentanil and propofol may be useful clinically.

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The growth of bacteria in infusion drugs: propofol 2% supports growth when remifentanil and pantoprazole do not

Abstract: Propofol strongly supports the growth of the microorganisms tested, although remifentanil and pantoprazole do not. Therefore, it is important to follow the strict aseptic techniques for the preparation of propofol.

Cited by 7 publications

References 25 publications

Growth of Microorganisms in Propofol and Mixture of Propofol, Lidocaine and Fentanyl

Growth of Microorganisms in Propofol and Mixture of Propofol, Lidocaine and Fentanyl

The antimicrobial activity of ephedrine and admixture of ephedrine and propofol: an in vitro study

The effect of concentration, reconstitution solution and pH on the stability of a remifentanil hydrochloride and propofol admixture for simultaneous co-infusion

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