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Predosing Chemical Stability of Admixtures of Propofol, Ketamine, Fentanyl, and Remifentanil

Bedocs, Peter MD, PhD*,†; Evers, David L. PhD; Buckenmaier, Chester C. III MD*,†

doi: 10.1213/ANE.0000000000003772
Preclinical Pharmacology

Admixtures of propofol–ketamine, propofol–ketamine–fentanyl, and propofol–ketamine–remifentanil were subjected to various clinically relevant conditions to study their chemical stability. A novel high-performance liquid chromatography-mass spectrometry method revealed no degradation of any compound by incubation at 37°C, constant mixing, or table-top storage for 6- and 24-hour time periods, except variable recovery of both propofol and fentanyl in the admixtures of propofol–ketamine–fentanyl suggesting possible degradation.

From the *Defense and Veterans Center for Integrative Pain Management, Henry M. Jackson Foundation, Rockville, Maryland

Uniformed Services University, Bethesda, Maryland

Walter Reed National Military Medical Center, Bethesda, Maryland.

Published ahead of print 1 August 2018.

Accepted for publication August 1, 2018.

Funding: US Army Medical Research and Materiel Command.

The authors declare no conflicts of interest.

The views expressed in this article are those of the authors and do not reflect the official policy of the Uniformed Services University, Departments of the Army, Navy, or Air Force, Department of Defense, Department of Veterans Affairs, or the US Government.

Reprints will not be available from the authors.

Address correspondence to Peter Bedocs, MD, PhD, Defense and Veterans Center for Integrative Pain Management, Henry M. Jackson Foundation, 11300 Rockville Pike, Suite 709, Rockville, MD 20852. Address e-mail to

Copyright © 2018 International Anesthesia Research Society
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