Stability of dexmedetomidine, ketamine and lidocaine combined injectable solution for analgesia
Bibliographic record
Abstract
BACKGROUND: In the context of the opioid epidemic, it is indispensable to reduce the use of opioids and develop new therapeutic alternatives. The combined use of ketamine, lidocaine and dexmedetomidine has been studied for opioid-free anaesthesia and the management of pain to reduce the use of opioids. An opioid-free anaesthesia mixture in one syringe for multimodal anaesthesia has been used in case series and is currently being studied in clinical trials. However, there are no data evaluating the compatibility of the admixture of these three drugs in syringes. The objective of this study was to evaluate the physicochemical stability of the combination of dexmedetomidine, ketamine and lidocaine. METHODS: The formulation combining the three active drugs was prepared at a final concentration of 1 µg/mL of dexmedetomidine, 1 mg/mL of ketamine and 10 mg/mL of lidocaine. The formulation was conditioned in syringes; three syringes were placed at 21°C and three others at 5°C. The concentration and the particle count were evaluated at predetermined time points up to 9 days. A validated stability-indicating HPLC method was developed. RESULTS: The study demonstrated the stability of ketamine (1 mg/mL) and lidocaine (10 mg/mL) in the injectable formulation when stored in polypropylene syringes at 5°C and 21°C for up to 9 days. However, dexmedetomidine (1 µg/mL) was stable for 9 days at 5°C, but only for 3 days when stored at 21°C. Therefore, the injectable formulation containing the three active compounds should be stored at 5°C in order to remain stable for 9 days. The particle count was below the threshold for injectable solution for 9 days at both temperatures. CONCLUSION: This study demonstrated the stability of dexmedetomidine (1 µg/mL), ketamine (1 mg/mL) and lidocaine (10 mg/mL) when stored in a polypropylene syringe at 5°C for up to 9 days.
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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".