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ORIGINAL RESEARCH article

Front. Vet. Sci.
Sec. Anesthesiology and Animal Pain Management
Volume 11 - 2024 | doi: 10.3389/fvets.2024.1365679

Contamination of Liposomal Bupivacaine during Multi-dose Usage in a Clinical Setting Evaluated by Culture and PCR

Provisionally accepted
Rachel L. Melvin Rachel L. Melvin Jing Wu Jing Wu Brad S. Bennett Brad S. Bennett Sara D. Lawhon Sara D. Lawhon Amy Savarino Amy Savarino Artem S. Rogovskyy Artem S. Rogovskyy Kelley M. Thieman Mankin Kelley M. Thieman Mankin *
  • Texas A and M University, College Station, United States

The final, formatted version of the article will be published soon.

    Liposomal bupivacaine, a long-acting local anesthetic, is sold in single-dose vials at a cost of approximately $200/20 mL vial. As many veterinary patients are not dosed an entire vial, the vials have been used for multiple doses at our institution to provide cost savings. Multiple punctures of a vial can lead to increased opportunity for contamination of the contents. This study aims to describe our institutional procedure for multi-dose use of single-dose liposomal bupivacaine vials and to evaluate clinically utilized liposomal bupivacaine for bacterial and fungal contamination using molecular and bacteriological methods. The first (Control) and last (Sample B) 0.5 mL from each vial were collected and submitted for bacterial and fungal PCR, anaerobic and aerobic bacterial culture, and opportunistic fungal culture. All 40 bacterial cultures yielded no growth; Bacterial or fungal DNA was identified in 19 samples (50%). Of the 19 samples in which bacterial or fungal DNA was identified, 10 (52.6%) were from Control, and 9 (47.4%) were from Sample B.PCR does not appear to be useful in detecting bacterial or fungal contamination from liposomal bupivacaine. Results support the aseptic handling protocol described in this article is successful in preventing detectable bacterial and fungal contamination of liposomal bupivacaine vials for up to 7 individual punctures and vials open for up to 5 days.

    Keywords: liposomal1, bupivacaine2, PCR3, culture4, NOCITA TM 5, multi-dose6

    Received: 05 Mar 2024; Accepted: 03 Sep 2024.

    Copyright: © 2024 Melvin, Wu, Bennett, Lawhon, Savarino, Rogovskyy and Thieman Mankin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Kelley M. Thieman Mankin, Texas A and M University, College Station, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.