Nemec K, Germ E, Schulz-Siegmund M, Ortner A
Hospital Pharmacy Department, SMZ-Ost/Donauspital Wien, Vienna.
Pharmazie. 2009 Feb;64(2):94-7.
Nimodipine is used parenterally to treat ischemic neurological deficits caused by subarachnoid haemorraghe. Infusion of nimodipine should be continued during anaesthesia, surgery or angiography. In this context a simultaneous administration of nimodipine, propofol and fentanyl or remifentanil could be of great advantage. So the aim of this study was to evaluate the physical stability (droplet size) of propofol emulsions in combination with nimodipine and fentanyl/remifentanil. Droplet size of intravenous emulsions is of particular relevance as the administration of larger droplets to patients may cause pulmonary embolism. So the number of oil droplets > 10 microm was determined in combinations of propofol emulsion with nimodipine and fentanyl/remifentanil immediately after mixing and after 20 hours by using microscopy. The experiments showed that all combinations of propofol (1 and 2%) with nimodipine infusion solution resulted in coalescence of oil droplets, which finally caused a visible phase separation. Macrogol (polyethylene glycol 400) was identified as the component in nimodipine infusion solution which induced the physicochemical incompatibility with propofol lipid emulsions.
尼莫地平用于胃肠外给药，以治疗蛛网膜下腔出血引起的缺血性神经功能缺损。在麻醉、手术或血管造影期间应持续输注尼莫地平。在这种情况下，同时给予尼莫地平、丙泊酚和芬太尼或瑞芬太尼可能具有很大优势。因此，本研究的目的是评估丙泊酚乳剂与尼莫地平及芬太尼/瑞芬太尼联合使用时的物理稳定性（液滴大小）。静脉乳剂的液滴大小尤为重要，因为给患者输注较大液滴可能会导致肺栓塞。因此，通过显微镜检查，在混合后立即以及20小时后，测定丙泊酚乳剂与尼莫地平及芬太尼/瑞芬太尼组合中直径大于10微米的油滴数量。实验表明，丙泊酚（1%和2%）与尼莫地平输注溶液的所有组合均导致油滴聚结，最终导致明显的相分离。聚乙二醇400被确定为尼莫地平输注溶液中与丙泊酚脂质乳剂发生理化不相容性的成分。
