Infusion Stability And Pharmacoeconomic Study Of Medication Administration Via Patient Controlled Analgesia Pump

Objectives1.To study the stability of the mixture of dezocine,ketorolac tromethamine and tropisetron hydrochloride in 0.9%sodium chloride infusion stored in the silicone rubber material based analgesia pump reservoir.2.To explore and compare the postoperative analgesic effect and adverse reaction among dezocine/tropisetron,dezocine/ketorolac tromethamine/tropisetron,and dezocine/sufentanil/tropisetron in the patient controlled intravenous analgesia(PCIA)treatment for orthopedic operation.Then to evaluate pharmacoeconomics of these three groups of formulations above.Methods1.The admixture was stored at 4℃,25℃ and 35℃ separately for 72h.The changes of pH value,insoluble particles and the relative contents were studied with pH meter,particle analyzer and high performance liquid chromatography,respectively.2.A retrospective case study was conducted by analysis of anesthesiologists’postoperative follow-up records,postoperative nursing records and medical orders.The postoperative analgesic effects and adverse drug reactions following PCIA treatment with three formulations within 48h were compared among patients receiving artificial femoral head replacement or total hip arthroplasty.A cost-effectiveness analysis was performed to evaluate pharmacoeconomics of three formulations.Results1.Stability study:No significant changes were found in appearance and pH value of the solution in the silicone rubber material analgesia pump reservoir under 4℃,25℃ and 35℃ within 72h.The number of insoluble particles was complied with Chinese Pharmacopoeia requirements.The relative contents of dezocine,ketorolac tromethamine and tropisetron hydrochloride were retained at 96%-102%.2.Pharmacoeconomic evaluation:(1)The VAS score at rest in the group of dezocine/sufentanil/tropisetron was significantly lower than that in the group of dezocine/tropisetron(P<0.05);(2)The postoperative analgesic effective rate of three groups were 85.71%,88.89%and 83.33%,respectively.The difference was not statistically significant(P>0.05);(3)The occurrence rate of adverse drug reactions in patients receiving dezocine/tropisetron was significantly higher compared with dezocine/ketorolac tromethamine/tropisetron,and dezocine/sufentanil/tropisetron(P<0.05);(4)The dezocine/sufentanil/tropisetron group had the lowest cost and cost effectiveness.Conclusion1.Dezocine,ketorolac tromethamine and tropisetron hydrochloride are stable in 0.9%sodium chloride infusion stored in the silicone rubber material based analgesia pump reservoir within 72h under 4℃,25℃ and 35℃.2.Dezocine/sufentanil/tropisetron is a relatively economic and effective postoperative analgesic formula.