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Korean Journal of Anesthesiology 2000;38(6):1075-1080.
DOI: https://doi.org/10.4097/kjae.2000.38.6.1075   
The Compatibility of Mixed Solutions of Ketorolac Tromethamine with Nalbuphine HCl.
Tae Soo Hahm, Jie Ae Kim, Sang Min Lee
Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
BACKGROUND
In patient-controlled analgesia (PCA), ketorolac tromethamine has been mixed with nalbuphine HCL in the same PCA balloon or syringe. The compatibility of mixed drugs is an important factor in determining the effects of the administered drugs, so we examined the compatibility of the mixed solution of the both drugs in various dilutions.
METHODS
Ketorolac tromethamine (K1, 3, 7, 19 group; n = 10/group) or nalbuphine HCl (N1, 3, 7, 19 group; n = 10/group) was diluted 1: 1, 3, 7, or 19 with normal saline and then the other drug was added. The presence of precipitates, turbidity by visual and spectrophotometric methods, and the pH of the mixed solutions were evaluated 0, 1, 6, 12 and 24 hours later.
RESULTS
Precipitates were observed in all studied solutions except in solutions of nalbuphine HCl diluted 1 : 19 with normal saline plus ketorolac tromethamine at the observed intervals. Turbid changes were observed in N1, 3, K1, 3, and 7, but significantly decreased from 6 hours after mixing. The pH of the K groups were significantly lower than those of the N groups.
CONCLUSIONS
The mixed solutions of ketorolac tromethamine with nalbuphine HCl were visually incompatible in almost all studied cases, so careful considerations are needed in mixing ketorolac tromethamine with nalbuphine HCl.
Key Words: Interactions, drug: incompatibility; ketorolac tromethamine, nalbuphine HCl
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