Physicochemical stability of ternary admixtures of butorphanol, ketamine, and droperidol in polyolefin bags for patient-controlled analgesia use

Abstract

BackgroundDelivery of drug admixtures by intravenous patient-controlled analgesia is a common practice for the management of postoperative pain; however, analytical confirmation of the compatibility and stability of butorphanol tartrate, ketamine hydrochloride, and droperidol combined in ternary admixtures is not available.MethodsButorphanol tartrate, ketamine hydrochloride, and droperidol have been examined for compatibility and stability when combined with 0.9% sodium chloride injection stored at 4°C and 25°C with light protection for a total of 14 days. Concentrations were 0.067 mg/mL, 1.33 mg/mL, and 0.033 mg/mL for butorphanol tartrate, ketamine hydrochloride, and droperidol, respectively. Drug concentrations were determined using high-performance liquid chromatographic analysis.ResultsAll three drugs were very stable (>97%) at 4°C and 25°C for 14 days. The ternary admixtures were initially clear and colorless throughout the observation period, and the pH value did not change significantly.ConclusionThe results confirm that the ternary admixture of butorphanol tartrate 0.067 mg/mL, ketamine hydrochloride 1.33 mg/mL, and droperidol 0.033 mg/mL in 0.9% sodium chloride injection were stable for 14 days when stored in polyolefin bags at 4°C and 25°C and protected from light.

Compatibility and stability of dezocine and tropisetron in 0.9% sodium chloride injection for patient-controlled analgesia administration

“…Furthermore, the benefits of excellent stability and compatibility of drugs will guarantee satisfactory therapeutic outcomes and reduce adverse reactions caused by degradation products. [24] Many clinical studies have evaluated the efficacy of tropisetron hydrochloride as an adjunct to dezocine PCA for providing superior pain relief, and the combination of dezocine and tropisetron hydrochloride has been accepted for the prevention of dezocine-induced PONV. [11,12,25] However, to our knowledge, there are no reports to date regarding the compatibility and stability of such mixtures for PCA.…”

Stability study of dezocine in 0.9% sodium chloride solutions for patient-controlled analgesia administration

“…Stability studies may have a variety of aims, including time management and reductions in cost, waste, and workload. [ 13 ] At the authors’ institution, more than 800 vials of dezocine are used monthly; therefore, extending the expiry date of these analgesia solutions would be beneficial.…”

Stability evaluation of morphine, hydromorphone, metamizole and esketamine containing analgesic mixtures applied for patient‐controlled analgesia in hospice and palliative care

“…However, it is also well known that combining two or more substances can lead to physical as well as chemical changes in the initial compounds of a mixture (Connors et al, 1986;Gikic et al, 2000;O'Connell & Haile, 2011). As a result, combinations of different analgesics may also have an effect on the chemical stability of single chemicals, which has already been investigated in numerous publications (Chen et al, 2014(Chen et al, , 2015(Chen et al, , 2018Fang et al, 2016Fang et al, , 2017Gu et al, 2015;Lee et al, 2020;Selbach et al, 2011). When injection mixtures are administered over several days or weeks, compounds can degrade and/or react with other substances, especially when exposed to moisture, light, ambient air or elevated temperatures.…”