Short term stability of pH-adjusted lidocaine-adrenaline epidural solution used for emergency caesarean section

Neurologic Complication Due to Crystallization After Drug Interaction Between Alkalized Lidocaine and Ropivacaine: A Case Report and in vitro Study

“…All the medicine and materials were kept in a 37°C incubator 30 min prior to use, and each mixture was prepared freshly. The pH of each medicine and mixture were recorded within 10 min, and observed with 1 h. For the short-term stability of pH-buffering ( 8 ), this test was repeated six times in all. The pH values of each medicine and mixture are presented in Figure 1A , and the values of L alk with ropivacaine ranged from 7.03 to 7.36.…”

The extension of epidural blockade for emergency caesarean section: a survey of Scandinavian practice

“…22,23 The authors are unaware of any pre-prepared mixtures containing lidocaine, adrenaline and bicarbonate (and possibly an opioid) available in the three surveyed countries, possibly be due to degradation of adrenaline when mixed with bicarbonate. 24 Consequently, anaesthesiologists must prepare the mixture immediately before use, despite the fact that the time spent and increased risk of drug errors may not justify the time saved by using the drug combination. Use of bicarbonate in the topup mixture by Scandinavian specialists may be limited by uncertainties about how much the onset of analgesic Epidural top-ups for caesarean section effect can be accelerated, and how much more likely is the risk of drug error.…”