Comparative growth dynamics of bacterial and fungal contaminants in bupivacaine liposomal injectable suspension, bupivacaine 0.5%, and propofol

Abstract

Objective To determine whether bupivacaine liposomal injectable suspension (BLIS) supports microbial growth when artificially inoculated and to evaluate liposomal stability in the face of this extrinsic contamination as evidenced by changes in free bupivacaine concentrations. Study design A randomized, prospective in vitro study in which three vials of each BLIS, bupivacaine 0.5%, and propofol were individually inoculated with known concentrations of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans (n = 36) to quantify bacterial and fungal growth was conducted. Over 120 hours, aliquots from contaminated vials were withdrawn, plated, and incubated to determine microbial concentrations. High-pressure liquid chromatography (HPLC) was used to evaluate free bupivacaine concentrations over time in BLIS. Data were analyzed using a mixed effects model with multiple comparisons. Sample population Twelve vials of each BLIS, bupivacaine 0.5%, and propofol. Results BLIS did not support significant growth of Staphylococcus aureus or Candida albicans at any time. BLIS supported significant growth of Escherichia coli and Pseudomonas aeruginosa beginning at the 24 hour time point. Bupivacaine 0.5% did not support significant growth of any organisms. Propofol supported significant growth of all organisms. Free bupivacaine concentrations changed minimally over time. Conclusion Bacterial and fungal contaminant growth in artificially inoculated BLIS is organism dependent. BLIS supports significant growth of Escherichia coli and Pseudomonas aeruginosa. Extra-label handling of BLIS should only be undertaken with caution and with adherence to strict aseptic technique.

Contaminación del propofol, expuesto a diferente temperatura ambiente

“…Fuente: (Wallace, Love, & Gensler, 2023) Según el estudio Wallace, Love, & Gensler (2023), el estudio investigó el crecimiento de bacterias y contaminantes en suspensión inyectable de diferentes anestésicos como lo son liposomal de bupivacaína (BLIS), bupivacaína 0,5% y propofol. Se realizó un estudio in En conclusión, los otros anestésicos no mostraron un crecimiento bacteriano en cambio en el caso del propofol apoyó el crecimiento significativo de los organismos contaminantes, lo que refuerza la importancia del manejo adecuado y la administración del propofol.…”

Interrelations Between Surgical Outcome and Bone, Spring and Surgical Parameters in Scaphocephalic Skulls Treated with Spring‐Assisted Cranioplasty

“…Elastic modulus and Poisson's ratio of the sutures were 8.3 MPa and 0.49 whereas Poissons' ratio of the bones was 0.22 in all simulations. [21] The modelling framework to simulate spring-assisted cranioplasty in sagittal synostosis is summarized in Figure 5.…”

“…[20] In these studies, the mechanical properties of the skull and sutures were adjusted to obtain outcomes as in the available post-operative patient-specific clinical images. Jacob and Bozkurt [21] used finite element analysis simulations to evaluate spring-assisted sagittal synostosis correction over a range of parameters and trained machine learning algorithms to predict surgical outcomes. Nonetheless, the surgical outcome in springassisted sagittal synostosis depends on multiple factors such as the mechanical properties of the skull and springs, force vectors applied by the springs, bone thickness, number of springs and osteotomy sizes.…”

“…Nonetheless, the surgical outcome in springassisted sagittal synostosis depends on multiple factors such as the mechanical properties of the skull and springs, force vectors applied by the springs, bone thickness, number of springs and osteotomy sizes. [14,21,22] However, the correlation between the surgical outcome and the skull, spring and surgical parameters remains unclear. It is also unclear whether the developed computational models can be used as true digital twins to predict the surgical outcomes in spring-assisted sagittal synostosis correction in the absence of postoperative clinical images.…”