Harmonising IV Oxycodone with Paediatric Perioperative Medications: A Compatibility Study Through Y-Type Connectors

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Drug Compatibility Studies

Background:

• Co-administering multiple intravenous (IV) agents via Y-connectors is standard practice for hospitalized and surgical patients.
• Concerns about physical incompatibilities limit concurrent administration of IV oxycodone with other drugs, potentially worsening acute pain.
• Limited data exists on the physical compatibility of IV oxycodone with frequently co-administered medications and IV fluids.

Purpose of the Study:

• To evaluate the physical compatibility of IV oxycodone with common drugs and IV fluids.
• To provide data that can inform safe co-administration practices in perioperative care.
• To address concerns that may lead to suboptimal pain management due to drug incompatibility fears.

Main Methods:

• Mixtures of IV oxycodone (1mg/mL) with various drugs and IV fluids were prepared at a 1:1 ratio.
• Assessments included visual inspection (precipitation, turbidity, color change, gas formation), spectrophotometry, and pH change at 0 and 60 minutes.
• Tested agents included ketamine, tramadol, clonidine, vancomycin, piperacillin/tazobactam, dexmedetomidine, cefotaxime, gentamicin, paracetamol, and several common IV fluids and TPN solutions.

Main Results:

• IV oxycodone (1mg/mL) exhibited no visual changes in any mixture.
• No spectrophotometric absorption variability at 350, 410, or 550nm was observed.
• No significant pH changes (>0.5) occurred at 0 or 60 minutes for any tested combination.

Conclusions:

• IV oxycodone at 1mg/mL is physically compatible with all tested drugs and IV fluids at a 1:1 ratio for at least 60 minutes.
• Findings support the co-administration of IV oxycodone with these agents, adhering to European Consensus Conference Standards.
• This compatibility data can help prevent interruptions in infusions and improve acute pain management in perioperative settings.