Stability of buprenorphine, haloperidol and glycopyrrolate mixture in a 0.9% sodium chloride solution.

Combinations of opioids and adjuvant drug solutions are often used in clinical practice while little information is available on their microbiological or chemical stability. Currently there are no commercially available, prepacked, ready-to-use epidural or subcutaneous mixtures. Thus, epidural and subcutaneous analgesic mixtures must be prepared in the pharmacy on an as-needed basis. Such mixtures are typically used for the treatment of severe pain in cancer patients. The aim of this study was to investigate the microbiological and chemical stability of a buprenorphine, haloperidol and glycopyrrolate mixture in a 0.9% sodium chloride solution. A high performance liquid chromatographic (HPLC) method and pH-meter were used to conduct the analyses. Antimicrobial activity of each component was studied by an agar dilution method. According to the results from the chemical and microbiological stability studies, this mixture can be stored in polypropylene (PP) syringes and polyvinyl chloride (PVC) medication cassettes for at least 30 days at either 21 degrees C or 4 degrees C, and for 16 days in PP syringes at 36 degrees C, and for 9 days in PVC medication cassettes at 36 degrees C.

Stability of Sufentanil in a Syringe Pump under Simulated Epidural Infusion.

Sufentanil is a potent micro-opioid and centrally acting analgesic. In the management of acute postoperative pain, sufentanil is often administered epidurally using a standard syringe pump. For epidural administration, sufentanil is diluted to a concentration of 1 to 2 micrograms/mL with 0.9% sodium chloride injection. The stability of sufentanil in a syringe pump under simulated epidural infusion was studied using a stability-indicating high-performance liquid chromatography method. The concentration of sufentanil was determined in polypropylene syringes connected with a polyethlyene or polyvinyl chloride (PVC) tubing, filter and epidural catheter. Sufentanil concentrations remained constant in polypropylene syringes connected to epidural catheters and in the whole epidural infusion system using polyethylene tubing. Sufentanil concentrations decreased 7% to 15% in syringes connected to PVC tubing, polyethylene tubing and the whole epidural infusion system using PVC tubing. Adsorption of 17% of the sufentanil onto an epidural filter occurred during the first hour of the infusion; thereafter, sufentanil concentration remained stable at levels that were 5% to 15% below the theoretical concentration. In conclusion, adsorption of sufentanil should be considered when a new filter and tubing of different materials are used.