Stability of Ketamine–Propofol Mixtures for Procedural Sedation and Analgesia in the Emergency Department
Bibliographic record
Abstract
ABSTRACTBackground: The mixture of ketamine and propofol administered together is reportedly an effective agent for procedural sedation and analgesia in the emergency department. However, the physical compatibility and chemical stability of extemporaneous solutions prepared from generic formulations of the drugs are not known.Objective: To investigate the physical compatibility and chemical stability of 50:50 and 30:70 mixtures of generic ketamine and propofol packaged in polypropylene syringes and stored at room temperature (23°C) with exposure to light.Methods: Mixtures of ketamine (10 mg/mL) and propofol emulsion (10 mg/mL) were prepared at 50:50 and 30:70 ratios, packaged in capped polypropylene syringes (3 syringes for each mixture), and stored at room temperature with exposure to light. One sample from each syringe was analyzed in duplicate at time 0 and after 1 and 3 h. Physical changes such as pH, separation or cracking of the emulsion, change in colour, and formation of gas were monitored. The chemical stability of each drug was assessed by high-performance liquid chromatography.Results: Both mixtures of ketamine and propofol were physically compatible during storage for up to 3 h. There were no signs of change in any of the physical parameters during the 3-h study. Each drug retained at least 97% of its original concentration.Conclusion: Mixtures of ketamine and propofol at 50:50 and 30:70 ratios were physically compatible and chemically stable for up to 3 h when stored in capped polypropylene syringes at room temperature with exposure to light.RÉSUMÉContexte : L’association kétamine-propofol semble être efficace pour induire une sédation et une analgésie d’intervention aux urgences. Cependant, on ne connaît pas la compatibilité physique et la stabilité chimique des solutions extemporanées de cette association, préparées à partir des génériques de ces deux médicaments.Objectif : Analyser la compatibilité physique et la stabilité chimique de mélanges 50:50 et 30:70 de kétamine et de propofol génériques conditionnés dans des seringues de polypropylène qui ont été conservées à la température ambiante (23°C) et exposées à la lumière.Méthodes : Des mélanges de kétamine (10 mg/mL) et de propofol en émulsion (10 mg/mL) ont été préparés dans des rapports de 50:50 et 30:70, puis conditionnés dans des seringues de polypropylène munies d’un capuchon (3 seringues pour chaque mélange) qui ont été entreposées à la température ambiante et exposées à la lumière. Un échantillon de chaque seringue a subi une double analyse au temps 0, puis après 1 et 3 heures. Chaque échantillon a été examiné à la recherche de changements physiques, notamment les changements de pH, la séparation de l’émulsion, le changement de couleur et la formation de gaz. La stabilité chimique de chaque médicament a été déterminée par chromatographie liquide haute performance.Résultats : Les deux mélanges de kétamine et de propofol étaient physiquement compatibles durant l’entreposage pendant une période allant jusqu’à 3 heures. Aucun signe de changement dans aucun des paramètres physiques n’a été observé pendant la période d’étude de 3 heures. Chaque médicament a conservé au moins 97 % de sa concentration initiale.Conclusion : Les mélanges de kétamine et de propofol dans un rapport de 50:50 et de 30:70 étaient physiquement et chimiquement stables pendant une période allant jusqu’à 3 heures, lorsqu’ils étaient entreposés dans des seringues de polypropylène munies d’un capuchon, à la température ambiante, et exposées à la lumière.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".