How long do prepared epidural solutions remain sterile?

Area of Science:

• Oncology
• Pharmacy
• Infectious Disease

Background:

• Cancer pain management often requires long-term epidural infusions.
• Maintaining sterility of epidural solutions in an outpatient setting is crucial for patient safety.
• Preservative-free solutions are sometimes necessary but raise concerns about microbial growth during storage.

Purpose of the Study:

• To assess the sterility of epidural solutions prepared in an outpatient pharmacy.
• To determine if refrigeration affects the sterility of these solutions for up to 14 days.
• To evaluate the safety and efficacy of refrigerated epidural solutions for home use in cancer patients.

Main Methods:

• Epidural solutions were prepared using sterile techniques at a tertiary cancer facility.
• Sterility testing was performed at preparation and after 14 days of refrigeration.
• 84 samples were tested over a seven-month period.
• Patient outcomes, including pain relief and infection evidence, were monitored.

Main Results:

• No instances of epidural solution colonization were detected in any of the 84 samples.
• All tested solutions remained sterile after 14 days of refrigeration.
• Patients experienced effective pain relief with ambulatory epidural infusions.
• No patients developed clinical evidence of infection related to the epidural solutions.

Conclusions:

• Preservative-free epidural solutions, prepared aseptically, can be safely refrigerated for up to 14 days.
• This practice is suitable for selected ambulatory cancer patients with severe pain managed at home.
• Sterile preparation and refrigeration are effective strategies for maintaining the safety of epidural infusions in home care settings.