• Paediatric anaesthesia · Jul 2022

    Compatibility of intravenous acetaminophen with morphine, fentanyl and ketamine in acute pediatric pain setting.

    • Edmond O'Loughlin, Yan Ghee Peng, Angela Cheaib, ChanMatthew T VMTV0000-0002-3574-7855Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong., and Robin Williams.
    • Department of Anaesthesia, Pain and Perioperative Medicine, Fiona Stanley and Fremantle Hospital Group, Murdoch, WA, Australia.
    • Paediatr Anaesth. 2022 Jul 1; 32 (7): 862-869.

    BackgroundIntravenous 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.AimsWe 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).MethodsAcetaminophen 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.ResultsAll solutions tested, for both acetaminophen and the three analgesics, had more than 90% of the drug recovery, up to 60 min after mixing.ConclusionOur data demonstrated the stability of acetaminophen, in combination with fentanyl, morphine, and ketamine at clinical concentrations used in acute pediatric pain setting.© 2022 John Wiley & Sons Ltd.

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