Heiderich Sebastian, Jürgens Jonas, Rudolf Daniel, Dennhardt Nils, Echtermeyer Frank, Leffler Andreas, Sümpelmann Robert, Lichtinghagen Ralf, Witt Lars
Clinic of Anesthesiology, Hanover Medical School, Hanover, Germany.
Institute for Clinical Chemistry, Hanover Medical School, Hanover, Germany.
Paediatr Anaesth. 2016 Jun;26(6):590-8. doi: 10.1111/pan.12889. Epub 2016 Mar 24.
Acetate-containing balanced electrolyte solutions are frequently used for fluid therapy in pediatric anesthesia, but no studies investigating the compatibility with common anesthetic drugs are available.
To reveal possible incompatibilities between common anesthetic drugs and the acetate-containing balanced electrolyte solutions BS (Sterofundin ISO; B.Braun Melsungen AG, Melsungen, Germany) and BS-G1 (E148G1 Päd; Serumwerk Bernburg AG, Bernburg, Germany), with normal saline (NS) as control.
All tested infusion solutions were mixed 1 : 1 with 28 common anesthetic drugs in concentrations used in daily clinical practice. Electrical conductivity, pH, and turbidimetric light diffusion at 405 nm were measured. Macroscopic changes such as gross precipitation, change in color, or bubble formation were also assessed. All measurements were performed immediately after mixing as well as 30 and 60 min after.
The vast majority of drugs showed no significant change in pH, electric conductivity, turbidimetric detectable light diffusion, or macroscopic appearance after mixing with BS, BS-G1, and NS. Phenytoin immediately precipitated in response to all tested solutions as did diazepam. Thiopental precipitated after mixing with BS only.
Most of the tested drugs did not show any signs or evidence of incompatibility reactions. However, phenytoin and diazepam should not be in contact with the three tested solutions, including NS. Thiopental should be used with caution because it can precipitate in solutions with a low pH (e.g., BS).
含醋酸盐的平衡电解质溶液常用于小儿麻醉的液体治疗，但尚无关于其与常用麻醉药物相容性的研究。
以生理盐水（NS）为对照，揭示常用麻醉药物与含醋酸盐的平衡电解质溶液BS（Sterofundin ISO；德国梅尔松根市贝朗医疗公司）和BS - G1（E148G1 Päd；德国伯恩堡血清工厂）之间可能存在的不相容性。
将所有测试的输注溶液与28种日常临床使用浓度的常用麻醉药物按1:1混合。测量电导率、pH值以及405nm处的比浊光散射。还评估了肉眼可见的变化，如明显沉淀、颜色变化或气泡形成。所有测量均在混合后立即进行，以及混合后30分钟和60分钟进行。
绝大多数药物与BS、BS - G1和NS混合后，pH值、电导率、比浊法可检测的光散射或外观均无显著变化。苯妥英钠与所有测试溶液混合后立即沉淀，地西泮也是如此。硫喷妥钠仅与BS混合后沉淀。
大多数测试药物未显示任何不相容反应的迹象或证据。然而，苯妥英钠和地西泮不应与包括NS在内的三种测试溶液接触。硫喷妥钠应谨慎使用，因为它在低pH值溶液（如BS）中可能沉淀。
