Opioid-Free Anesthesia: Physico Chemical Stability Studies on Multi-Analyte Mixtures Intended for Use in Clinical Anesthesiology

Schenkel, Larissa; Kahmann, Irene Vogel

doi:10.1177/00185787211016336

Cited by 5 publications

(9 citation statements)

References 20 publications

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“…In selected carrier solutions, target analytes are selectively quantified against corresponding reference standards. Several reports are published showing the beneficial and ubiquitously applicable workflow of these instrumental procedures 6–8 …”

Section: Methodsmentioning

confidence: 99%

“…Autosampler was kept at 10°C and injection volume was 3 μL. Settings of the mass spectrometry (MS) detector are used as reported previously 8 . Analysis was done in electron spray ionisation positive mode.…”

Section: Methodsmentioning

confidence: 99%

“…Several reports are published showing the beneficial and ubiquitously applicable workflow of these instrumental procedures. [6][7][8]…”

Section: Analysis Of Drug Concentrationsmentioning

confidence: 99%

“…Settings of the mass spectrometry (MS) detector are used as reported previously. 8 Analysis was done in electron spray ionisation positive mode. Heated electron spray ionisation II source was set to 150°C.…”

Section: Chromatographic Conditionsmentioning

confidence: 99%

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Accuracy of Spinal Anesthesia Drug Concentrations in Mixtures Prepared by Anesthetists

Wiedemeier

Schwappach

2022

J Patient Saf

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Objective: Medication errors include the indirect dosing of drugs. For spinal anesthesia mixtures of local anesthetics, opioids are drawn from ampoules and combined in a syringe, according to clinical practice. We set out to determine the accuracy of the drug mixtures.Methods: Physicians of our department were invited to prepare the mixture used for spinal anesthesia for cesarean section, consisting of 10-mg hyperbaric bupivacaine (2-mL volume), 20-μg fentanyl (0.4-mL volume), and 100-μg morphine (0.1-mL volume). Concentrations of these drugs were determined by means of high performance liquid chromatography. Interindividual and intraindividual variations were assessed. Results:We analyzed 96 samples from 31 physicians. Fifty-one percent of the measured bupivacaine concentrations were in ±10% deviation range of the intended concentration; 17% of the fentanyl and 24% of the morphine concentrations were in this range. A total of 2.1% of the samples had a bupivacaine concentration corresponding to a dose of 8 mg or less, and 11.5% of the samples had a morphine concentration corresponding to a dose of 150 μg or greater. Intraindividual variations were 10.9% for bupivacaine, 24.7% for fentanyl, and 38.9% for morphine. Conclusions:Our results show a high deviation of the obtained from the intended concentrations. Two percent of the samples had bupivacaine concentrations that probably resulted into an insufficient analgesia, and 11% of the samples had morphine concentrations that, according to guidelines, would require a longer monitoring period than with the intended dose.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Several reports are published showing the beneficial and ubiquitously applicable workflow of these instrumental procedures. [6][7][8]…”

Section: Analysis Of Drug Concentrationsmentioning

confidence: 99%

Section: Chromatographic Conditionsmentioning

confidence: 99%

See 2 more Smart Citations

Accuracy of Spinal Anesthesia Drug Concentrations in Mixtures Prepared by Anesthetists

Wiedemeier

Schwappach

2022

J Patient Saf

Self Cite

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“…The classical methods for analyzing KET are chromatography, including gas chromatography (GC); [16][17][18][19] liquid chromatography (LC); [19][20][21] gas chromatography-mass spectrometry, 22,23 and liquid chromatography-mass spectrometry (LC-MS). [24][25][26][27] Gas chromatography-mass spectrometry was further developed into gas chromatography-single quadrupole mass spectrometry (GC-MS) and gas chromatography-tandem mass spectrometry (GC-MS/MS). Although these techniques offer excellent accuracy and sensitivity, they also display some disadvantages, including lack of portability, long test times, cumbersome and solventconsuming sample preparation steps, the need for skilled operators, high operation and maintenance costs, and nonsuitability for on-site analyses.…”

Section: Introductionmentioning

confidence: 99%

Competitive fluorescence immunoassay for the rapid qualitative screening and accurate quantitative analysis of ketamine

Cao

Chen

2022

RSC Adv.

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Comparison between multimodal and intraoperative opioid free anesthesia for laparoscopic sleeve gastrectomy: a prospective, randomized study

Mieszczański

Górniewski

Ziemiański

et al. 2023

Sci Rep

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Anesthesia for laparoscopic sleeve gastrectomy and perioperative management remains a challenge. Several clinical studies indicate that opioid-free anesthesia (OFA) may be beneficial, but there is no consensus on the most optimal anesthesia technique in clinical practice. The aim of our study was to assess the potential benefits and risks of intraoperative OFA compared to multimodal analgesia (MMA) with remifentanil infusion. In a prospective, randomized study, we analyzed 59 patients’ data. Primary outcome measures were oxycodone consumption and reported pain scores (numerical rating scale, NRS) at 1, 6, 12, and 24th hours after surgery. Postoperative sedation on the Ramsay scale, nausea and vomiting on the PONV impact scale, desaturation episodes, pruritus, hemodynamic parameters, and hospital stay duration were also documented and compared. There were no significant differences in NRS scores or total 24-h oxycodone requirements. In the first postoperative hour, OFA group patients needed an average of 4.6 mg of oxycodone while the MMA group 7.72 mg (p = 0.008, p < 0.05 statistically significant). The PONV impact scale was significantly lower in the OFA group only in the first hour after the operation (p = 0.006). Patients in the OFA group required higher doses of ephedrine 23.67 versus 15.69 mg (p = 0.039) and more intravenous fluids 1160 versus 925.86 ml (p = 0.007). The mode of anesthesia did not affect the pain scores or the total dose of oxycodone in the first 24 postoperative hours. Only in the first postoperative hour were an opioid-sparing effect and reduction of PONV incidence seen in the OFA group when compared with remifentanil-based anesthesia. However, patients in the OFA group showed significantly greater hemodynamic lability necessitating higher vasopressor doses and more fluid volume.

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Opioid-Free Anesthesia: Physico Chemical Stability Studies on Multi-Analyte Mixtures Intended for Use in Clinical Anesthesiology

Cited by 5 publications

References 20 publications

Accuracy of Spinal Anesthesia Drug Concentrations in Mixtures Prepared by Anesthetists

Accuracy of Spinal Anesthesia Drug Concentrations in Mixtures Prepared by Anesthetists

Competitive fluorescence immunoassay for the rapid qualitative screening and accurate quantitative analysis of ketamine

Comparison between multimodal and intraoperative opioid free anesthesia for laparoscopic sleeve gastrectomy: a prospective, randomized study

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