DG Journal Club
Paediatr Anaesth. 2022 Apr 10
BACKGROUND Intravenous acetaminophen and opioid analgesics are routinely given concurrently to children after major surgery, where intravenous access can be limited. There is limited information about the compatibility of acetaminophen with opioid analgesics and ketamine in concentrations commonly used in pediatric setting.
AIMS We aimed to determine the physical and chemical compatibility in mixtures of intravenous acetaminophen 10 mg/mL with morphine (0.025, 0.05, 0.1, 0.2, 1 and 2 mg/mL), fentanyl (0.5, 0.75, 1, 1.5, 2 and 5 mcg/mL) and ketamine (0.01, 0.1, 0.5, 1, 1.5 and 3 mg/mL).
METHODS Acetaminophen was mixed with all 18 solutions and was examined at time 0, 15, 30 and 60 min. In Phase one of the study, we used a colorimetric method to assess preliminary feasibility and acetaminophen recovery. In Phase two study, we used high performance liquid chromatography to evaluate the recovery of all components of the mixtures.
RESULTS All solutions tested, for both acetaminophen and the three analgesics, had more than 90% of the drug recovery, up to 60 min after mixing.
CONCLUSION Our data demonstrated the stability of acetaminophen, in combination with fentanyl, morphine and ketamine at clinical concentrations used in acute pediatric pain setting.