Phenylephrine Anesthesia Syringes

 

Phenylephrine injection 1mg 500

 

Edge Pharma offers phenylephrine operating room anesthesia syringes for use by hospitals and surgery centers.

 

Phenylephrine HCI

 

Concentration = 0.1 mg/mL 
Syringe Volume = 5 mL syringe

Concentration = 0.08 mg/mL
Syringe Volume = 10 mL syringe

Concentration = 0.1 mg/mL
Syringe Volume = 10 mL syringe

Storage: room temperature

Prefilled O.R. anesthesia syringes are an excellent solution enabling your facility to reduce waste and improve efficiency.  Edge Pharma provides the added comfort of knowing that your compounded outsourced medications are being produced in a CGMP compliant facility where every batch completes potency, endotoxin, and 14-day sterility testing prior to release.

 

Literature Review

 

Total Joint Replacement

 

“Total joint replacement (TJR) is one of the most commonly performed, elective surgical procedures in the United States, and the volume of primary and revision TJR procedures has risen continuously in recent decades,” according to a study presented at the 2018 meeting of The American Academy of Orthopedic Surgeons. The study reported there were 370,000 total hip replacements and 680,150 total knee replacements in the U.S. in 2014. Other findings include: 

  • By 2030, primary THR is projected to grow 171 percent and primary TKR is projected to grow by up to 189 percent for a projected 635,000 and 1.28 million procedures, respectively.
  • Similar gains are expected for revision THR and TKR, growing by 142 percent (72,000 procedures) and 190 percent (120,000 procedures) respectively.
  • By 2060, primary THR is expected to reach 1.23 million (330 percent increase), primary TKR is expected to reach 2.60 million (382 percent increase), revision THR is expected to reach 110,000 (219 percent increase), and revision TKR is expected to reach 253,000 (400 percent increase).(1)

Spinal anesthesia is a widely used anesthetic technique for elderly patients undergoing lower limb surgery. According to a study published in the Journal of Anesthesiology Clinical Pharmacology, “spinal anesthesia is often preferred for its efficacy, rapidity, minimal effect on mental status, reduction of blood loss, and protection against thrombo-embolic complications.” Still, it carries with it a risk of severe hypotension. “This is due to the rapid extension of the sympathetic block, hindering cardiovascular adaptation and causing significant morbidity and mortality.”(2)

A study published in the Journal of Clinical Anesthesia explored the effectiveness of prophylactic phenylephrine infusion to prevent hypotension after spinal anesthesia. The study included 54 patients 60 years and older undergoing elective lower limb surgery. The study found: “Prophylactic phenylephrine infusion (i.e. beginning immediately after the placement of spinal anesthesia) is an effective method of reducing SA-induced hypotension in the elderly. Compared with a control group, it delays the time to onset of hypotension and decreases the number of hypotensive episodes per patient. Prophylactic phenylephrine infusions appear to be safe regarding bradycardia or hypertension.(3)

An additional study, published in the Journal of Advanced Biomedical Research, compared the prophylactic effect of phenylephrine and ephedrine on hypotension during spinal anesthesia for hip fracture surgery. For the study, 92 patients undergoing hip fracture surgery were randomized to receive prophylaxis with ephedrine or phenylephrine immediately before the spinal anesthesia. The frequency of hypotension was found to be significantly lower in mean arterial pressure (MAP), systolic and diastolic pressure in the group given phenylephrine in 3, 6, and 9 minutes after spinal anesthesia. The study concluded: “At the doses of ephedrine and phenylephrine administered in this trial, phenylephrine was better to prevent hypotension during hip fracture surgery with spinal anesthesia. Higher frequency of hypotension was observed in the ephedrine group.”(4)

 


(1) Sloan, Matthew MD, Sheth, Neil P. MD, University of Pennsylvania study, Projected Volume of Primary and Revision Total Joint Replacement in the U.S. 2030 to 2060  https://aaos-annualmeeting-presskit.org/
(2) Goyal, Meenu, Taxak, Susheela, Kshetrapal, Kirti Kama, Goel, Manish, Kumar, Journal of Anesthesiology Clinical Pharmacology, Continuous Spinal Anesthesia in a High Risk Elderly Patient Using Epidural Set  https://www.ncbi.nlm.nih.gov/
(3) Ferre, Fabrice MD, Marty, Philippe MD, Bruneteau, Laura MD, Merlet, Virgine MD, Bataille, Benoit MD, Ferrier, Anne MD, Gris, Claude MD, Kurrek, Matt MD, Fourcade, Oliver MD, PhD, Minville, Vincent MD, PhD, Sommet, Agnes MD, PhD, Journal of Clinical Anesthesia, online article, Prophylactic Phenylephrine Infusion for the Prevention of Hypotension after Spinal Anesthesia in the Elderly: A Randomized Controlled Clinical Trial   https://www.sciencedirect.com/
(4) Abbasivash, Rahman, Sane, Shahryar, Golmohammadi, Mitra, Shokuhi, Shahram, Toose, Fereshteh Danaye, Journal of Advanced Biomedical Research, Comparing Prophylactic Effect of Phenylephrine and Ephedrine on Hypotension During Spinal Anesthesia for Hip Fracture Surgery  https://www.ncbi.nlm.nih.gov/
 

 

Phenylephrine After Hip Fracture Surgery

 

Each year more than 300,000 people in the U.S. over the age of 65 are hospitalized for hip fractures, according to the Centers for Disease Control. More than 95% of hip fractures are caused by falling.(1)

The American Academy of Orthopaedic Surgeons reports that the majority of hip fractures require surgical treatment within one to two days of injury. Since many patients are older, possibly with additional health problems, other specialists such as a cardiologist or pulmonologist may be involved in the patient’s care before surgery.(2)

Based on a number of factors, including age and the patient’s underlying health conditions, an anesthesiologist may choose general, spinal, or epidural anesthesia.(3) A study published in the Journal of Advanced Biomedical Research was aimed at comparing the effect of prophylactic phenylephrine versus ephedrine in the prevention of hypotension during spinal anesthesia in hip fracture surgery.

“Ninety-two patients undergoing hip fracture surgery with the America Society of Anesthesiologists I and II were randomized to receive prophylaxis with ephedrine or phenylephrine immediately before spinal anesthesia.” The study concluded that during this trial, phenylephrine was superior in preventing hypotension during hip fracture surgery. The frequency of hypotension was found to be significantly lower 3, 6, and 9 minutes after spinal anesthesia.(3)

 


(1) Centers for Disease Control, Hip Fractures Among Older Adults, https://www.cdc.gov/
(2) American Academy of Orthopaedic Surgeons, Hip Fractures, https://orthoinfo.aaos.org/
(3) Advanced Biomedical Research, Comparing Effect of Phenylephrine and Ephedrine on Hypotension During Spinal Anesthesia for Hip Fracture Surgery, https://www.advbiores.net/

 

 

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