The chemical stability of admixtures of injectable corticosteroid and local anaesthetics

Watson, D.G. and Husain, S. and Brennan, S. and Baird, J. and Finlayson, D. (2007) The chemical stability of admixtures of injectable corticosteroid and local anaesthetics. CME Orthopaedics, 4 (3). pp. 81-83. ISSN 1367-8957

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Intra-articular and soft tissue instillation of depot corticosteroids is used as an effective adjunct in managing rheumatoid arthritis, osteoarthritis and other connective tissue conditions. It is common practice to mix the steroid with a local anaesthetic agent prior to administration. The stability of methyl prednisolone when mixed with lidocaine has been assessed, however there is no evidence in the literature regarding the pharmacological stability of triamcinolone acetonide following admixture. Hypothesis: To determine the stability of admixture of injectable corticosteroid and local anaesthetic prior to injection in patients with arthritic conditions. Study design: Original laboratory based analysis. High performance liquid chromatographic (HPLC) analysis was used to assess the stability of combinations of triamcinolone and hydrocortisone when mixed with combinations of lignocaine and bupivacaine. Results: The results show that the combinations are stable when mixed together as judged by our pharmaceutical analysis. These results support the continued use of these products in combination for safe use in clinical practice. Clinical relevance: We have shown that it is safe practice to mix these two components prior to patient administration.