open access

Vol 50, No 3 (2018)
Original and clinical articles
Published online: 2018-07-08
Submitted: 2018-04-14
Accepted: 2018-06-13
Get Citation

Extended compatibility of fentanyl and ketamine in dextrose 5%

Suci Hanifah, Ross Kennedy, Patrick Ball
DOI: 10.5603/AIT.a2018.0022
·
Pubmed: 29982991
·
Anaesthesiol Intensive Ther 2018;50(3):221-225.

open access

Vol 50, No 3 (2018)
Original and clinical articles
Published online: 2018-07-08
Submitted: 2018-04-14
Accepted: 2018-06-13

Abstract

Background: There are no published studies that report on fentanyl and ketamine compatibility in dextrose 5%
solution as commonly practiced in hospital settings.


Methods: This study assessed the compatibility of fentanyl and ketamine after their reconstitution in dextrose 5%
under ambient temperature and humidity conditions in a hospital setting. Each sample of fentanyl and ketamine was
prepared in triplicate by adding dextrose 5% to a prefilled syringe until final concentrations of 9.8 μg mL-1 for fentanyl
and 192 μg mL-1 for ketamine were achieved. The solutions were stored in syringes at an ambient temperature ranging
26–28°C either under a mixture of daylight and ambient lighting. A sample was taken from the syringes at the
following times: 0, 8, 24, 72, 120, and 168 hours. The samples from each solution were checked for physical changes,
pH and their concentration assessed by high-performance liquid chromatography.


Results: The solutions were clear and no physical changes were seen. The pH of fentanyl and ketamine decreased
dramatically after 72 hours. The concentrations of fentanyl remained 90–110% only for 24 hours, while ketamine
remained 90–110% for 168 hours.


Conclusion: Solutions of fentanyl and ketamine in dextrose 5% may be used in prefilled syringes only up to 24 hours
and 72 hours after reconstitution, respectively.

Abstract

Background: There are no published studies that report on fentanyl and ketamine compatibility in dextrose 5%
solution as commonly practiced in hospital settings.


Methods: This study assessed the compatibility of fentanyl and ketamine after their reconstitution in dextrose 5%
under ambient temperature and humidity conditions in a hospital setting. Each sample of fentanyl and ketamine was
prepared in triplicate by adding dextrose 5% to a prefilled syringe until final concentrations of 9.8 μg mL-1 for fentanyl
and 192 μg mL-1 for ketamine were achieved. The solutions were stored in syringes at an ambient temperature ranging
26–28°C either under a mixture of daylight and ambient lighting. A sample was taken from the syringes at the
following times: 0, 8, 24, 72, 120, and 168 hours. The samples from each solution were checked for physical changes,
pH and their concentration assessed by high-performance liquid chromatography.


Results: The solutions were clear and no physical changes were seen. The pH of fentanyl and ketamine decreased
dramatically after 72 hours. The concentrations of fentanyl remained 90–110% only for 24 hours, while ketamine
remained 90–110% for 168 hours.


Conclusion: Solutions of fentanyl and ketamine in dextrose 5% may be used in prefilled syringes only up to 24 hours
and 72 hours after reconstitution, respectively.

Get Citation

Keywords

compatibility, fentanyl, ketamine, reconstitution, syringe

About this article
Title

Extended compatibility of fentanyl and ketamine in dextrose 5%

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 50, No 3 (2018)

Pages

221-225

Published online

2018-07-08

DOI

10.5603/AIT.a2018.0022

Pubmed

29982991

Bibliographic record

Anaesthesiol Intensive Ther 2018;50(3):221-225.

Keywords

compatibility
fentanyl
ketamine
reconstitution
syringe

Authors

Suci Hanifah
Ross Kennedy
Patrick Ball

References (14)
  1. Celis-Rodríguez E, Birchenall C, de la Cal MÁ, et al. Federación Panamericana e Ibérica de Sociedades de Medicina Crítica y Terapia Intensiva. Clinical practice guidelines for evidence-based management of sedoanalgesia in critically ill adult patients. Med Intensiva. 2013; 37(8): 519–574.
  2. Maciejewski D. Sufentanil in anaesthesiology and intensive therapy. Anaesthesiol Intensive Ther. 2012; 44(1): 35–41.
  3. Hoellein L, Holzgrabe U. Ficts and facts of epinephrine and norepinephrine stability in injectable solutions. Int J Pharm. 2012; 434(1-2): 468–480.
  4. Gupta VD, Stewart K. Stability of dobutamine hydrochloride and verapamil hydrochloride in 0.9% sodium chloride and 5% dextrose injections. Am J Health-System Pharm. 1984; 41(4): 686–689.
  5. Donnelly RF. Stability of diluted ketamine packaged in glass vials. Can J Hosp Pharm. 2013; 66(3): 198.
  6. Allen L, Stiles M, Tu YH. Stability of fentanyl citrate in 0.9% sodium chloride solution in portable infusion pumps. Am J Health-System Pharm. 1990; 47(7): 1572–1574.
  7. McCluskey SV, Graner KK, Kemp J, et al. Stability of fentanyl 5 microg/mL diluted with 0.9% sodium chloride injection and stored in polypropylene syringes. Am J Health Syst Pharm. 2009; 66(9): 860–863.
  8. Hanifah S. Mapping of incompatibility assay: bringing method to problem in critical care. Int J Pharm Pharmaceut Sci. 2014; 6(4): 171–173.
  9. Dong M, Gershanov P, Gershanov L. Getting the peaks perfect: system suitability for HPLC. Todays Chemist at Work. 2001; 10(9): 38–34.
  10. Dolan JW. Why do peaks tail? LCGC Eur. 2003; 21(7): 610–613.
  11. Kowalski S, Gourlay G. Stability of fentanyl citrate in glass and plastic containers and in a patient-controlled delivery system. Am J Health-System Pharm. 1990; 47(7): 1584–1587.
  12. Roos PJ, Glerum JH, Meilink JW. Stability of sufentanil citrate in a portable pump reservoir, a glass container and a polyethylene container. Pharmaceutisch Weekblad Scientific Edition. 1992; 14(4): 196–200.
  13. Kiser TH, Oldland AR, Fish DN. Stability of phenylephrine hydrochloride injection in polypropylene syringes. American Journal of Health-System Pharmacy. 2007; 64(10): 1092–1095.
  14. Stucki M. Development of ready-to-use ketamine hydrochloride syringes for safe use in post-operative pain. Eur J Hosp Pharm Sci . 2008; 14(1): 14–18.

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