Short term stability of pH-adjusted lidocaine-adrenaline epidural solution used for emergency caesarean section
Short term stability of pH-adjusted lidocaine-adrenaline epidural solution used for emergency caesarean section
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DOI：
10.1016/j.ijoa.2007.11.002
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发表时间：
2008-04-01
影响因子：
2.8
通讯作者：
Yentis, S. M.
中科院分区：
文献类型：
--
作者：
Tuleu, C.;Allam, J.;Yentis, S. M.
背景：利多卡因-碳酸氢钠-肾上腺混合物通常用于紧急剖宫产的硬膜外推注剂量。先前的研究表明，肾上腺素在混合24小时后完全降解。坊间调查表明，使用这种混合物的麻醉师通常会在使用前准备溶液，尽管缺乏关于其在0-24小时内稳定性的数据。本研究的目的是监测上述混合物中肾上腺素在20小时内的降解情况。方法：将8.4%碳酸氢钠2毫升加入2%利多卡因20毫升；丢弃其中2毫升，加入肾上腺素1：1000 0.1毫升。这些混合物储存在24摄氏度的塑料注射器中，没有光线保护(n=3)或黑暗(n=3)。同时制备非碱化对照。分别于0、2、4、6、20℃用高效液相色谱法测定肾上腺素和利多卡因的含量。结果：在光照下，重碳酸盐混合物中肾上腺素的化学降解在室温下很快，6h后仅有73.0+/-3.6%的肾上腺素残留。在黑暗中，肾上腺素的稳定性有所提高，6h后仍有95.8+/-3.6%的肾上腺素。在无碳酸氢盐存在的情况下，两种情况下肾上腺素的降解都很小。结论：不宜提前配制pH可调的利多卡因-肾上腺素混合物，不宜在光照下长时间保存。(C)2008爱思唯尔有限公司。保留所有权利。
Background: Lidocaine-bicarbonate-adrenal in e mixtures are commonly used for epidural bolus doses for emergency caesarean section. Previous research has shown that adrenaline degrades completely 24 h after mixing. Anecdotal enquiries suggest that anaesthetists who use such mixtures commonly prepare the solution ahead of use, despite a lack of data about its stability between 0 and 24 h. The aim of this study was to monitor the degradation of adrenaline in the above mixture over 20 h.Methods: 2 mL of sodium bicarbonate 8.4% was added to 20 mL of 2% lidocaine; 2 mL of this mixture was discarded and 0.1 mL of adrenaline 1:1000 added. The mixtures were stored in plastic syringes at 24 degrees C unprotected from light (n = 3) or in the dark (n = 3). Non-alkalinised controls were also prepared. Adrenaline and lidocaine were assayed by high performance liquid chromatography at 0, 2, 4, 6 and 20 It.Results: In the bicarbonated mixture exposed to light, chemical degradation of adrenaline was fast at room temperature, only 73.0 +/- 3.6% of adrenaline remaining after 6 It. In the dark, the stability of adrenaline improved and 95.8 +/- 3.6% remained after 6 h. Negligible degradation occurred in the absence of bicarbonate in either condition. Lidocaine concentrations remained unchanged regardless of the storage conditions.Conclusions: This study suggests that preparation of pH-adjusted lidocaine-adrenaline mixtures in advance and prolonged storage in the light is inadvisable. (c) 2008 Elsevier Ltd. All rights reserved.