Damitz Robert, Chauhan Anuj, Gravenstein Nikolaus
Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.
Rom J Anaesth Intensive Care. 2016 Apr;23(1):7-11. doi: 10.21454/rjaic.7518.231.emf.
Despite their widespread use for anesthesia and sedation, propofol emulsions have several unresolved issues, including pain on injection, stability concerns, and propensity to support bacterial growth. Pain accompanying a propofol injection has been attributed to the amount of free as opposed to emulsified propofol in the blood, which can differ with the formulation. Emulsions are inherently unstable and subject to several types of destabilization, but the actual mechanism may vary between formulations or batches. Free drug concentration and emulsion stability have not been widely studied between batches of propofol emulsions. Verifying whether batch-to-batch variability is a contributing factor to pain on injection or emulsion destabilization will help us better assess the causes and guide the design of future propofol formulations.
Several samples of generic 1% propofol emulsion from various batches were compared. Free drug concentration was measured using an equilibrium dialysis method. Emulsion stability was evaluated by visible observation and by measuring droplet size distribution and polydispersity during shelf storage for up to 21 months.
Small differences in free drug concentration were observed between samples (10.6-16.7 μg/mL), but these differences were not statistically significant (p > 0.05). Emulsion droplet size (235.4-221.1 nm) and polydispersity (0.115-0.095) did not differ statistically over 21 months of storage. All batches were resistant to creaming and other destabilization mechanisms.
Batch-to-batch variability does not significantly alter the free drug concentration or stability of propofol formulations. If pain on injection of propofol is in fact related to the free propofol drug concentration, then it is unlikely that batch-to-batch variability causes any changes in pain on propofol injection.
尽管丙泊酚乳剂在麻醉和镇静方面广泛应用,但仍存在一些未解决的问题,包括注射疼痛、稳定性问题以及支持细菌生长的倾向。丙泊酚注射时伴随的疼痛归因于血液中游离丙泊酚与乳化丙泊酚的量,这可能因制剂不同而有所差异。乳剂本质上不稳定,容易出现多种类型的失稳情况,但实际机制可能因制剂或批次而异。不同批次的丙泊酚乳剂之间,游离药物浓度和乳剂稳定性尚未得到广泛研究。验证批次间差异是否是注射疼痛或乳剂失稳的一个影响因素,将有助于我们更好地评估其原因,并指导未来丙泊酚制剂的设计。
比较了来自不同批次的几种通用1%丙泊酚乳剂样品。采用平衡透析法测量游离药物浓度。通过肉眼观察以及在长达21个月的货架期储存期间测量液滴大小分布和多分散性来评估乳剂稳定性。
样品间游离药物浓度存在微小差异(10.6 - 16.7μg/mL),但这些差异无统计学意义(p > 0.05)。在21个月的储存期内,乳剂液滴大小(235.4 - 221.1nm)和多分散性(0.115 - 0.095)在统计学上无差异。所有批次均抗分层及其他失稳机制。
批次间差异不会显著改变丙泊酚制剂的游离药物浓度或稳定性。如果丙泊酚注射疼痛实际上与游离丙泊酚药物浓度有关,那么批次间差异不太可能导致丙泊酚注射疼痛出现任何变化。