preservative free

[smarterchild]

I'm having a hard time sourcing preservative-free lidocaine. Do you think lidocaine with preservative is safe to use for joints, RFA, etc?

I don't typically inject local for epidurals, but do use PF if I have an acute radic.

Thanks

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[Ronin1]

I'm having a hard time sourcing preservative-free lidocaine. Do you think lidocaine with preservative is safe to use for joints, RFA, etc?

I don't typically inject local for epidurals, but do use PF if I have an acute radic.

Thanks

It’s fine outside of epidurals

 

[No_Pain_No_Gain]

Per SIS, no adverse events have ever been reported injecting local anesthetics with preservatives or steroids with preservatives into the epidural space. Just be careful not to inject intrathecal.

https://cdn.ymaws.com/sites/www.spineintervention.org/resource/resmgr/factfinder/Preservative-Free_ESI_9-10-2.pdf

 

[Laryngospasm]

Yes no preservatives in spinals

 

[smarterchild]

Thank you! Appreciate all the advice!

 

[pmrmd]

I don’t use PF anything and have never had a problem. Don’t sweat it.

 

[clubdeac]

I think the bigger risk is possibly having an allergic reaction to the preservative which also is very unlikely

 

[Ducttape]

no injectable is truly "preservative free".

these do have a preservative, typically citric acid, but based on FDA nomenclature, they are not considered a preservative...

 

[smarterchild]

Thanks all!

 

[painfree23]

I don’t use PF anything and have never had a problem. Don’t sweat it.

Wat about the steroids? Aren’t some with preservatives and some PF?

 

[pmrmd]

Wat about the steroids? Aren’t some with preservatives and some PF?

Steroids with preservative. In a multidose vial. Nothing bad happens.

 

[smarterchild]

Oh I’ve always been taught multi dose vials for steroids are a no-no. Is that not the case?

 

[pmrmd]

Oh I’ve always been taught multi dose vials for steroids are a no-no. Is that not the case?

For what reason are they a "no-no"? Preservatives don't matter. Multidose vials don't matter.

 

[Laryngospasm]

The same reason we have to throw away a big bottle of contrast after using 2cc.. it makes the companies more money. I mean it’s an infection risk.. sorry

 

[smarterchild]

I was taught (and I was trained in a fairly conservative fellowship) that it had to with the infection risk from inserting multiple needles into the same vial numerous times.

But I’m happy to hear you guys are using multi dose vials. It would save quite a bit of money as a 1cc vial of depo 40mg is close to $10 each around my neck of the woods

 

[NOSfan]

I was taught (and I was trained in a fairly conservative fellowship) that it had to with the infection risk from inserting multiple needles into the same vial numerous times.

Here's the CDC's FAQ on multi-dose vials......BTW some may not believe the CDC anymore 🙂

Questions about Multi-dose vials | Injection Safety | CDC

 

[clubdeac]

we discussed this ad nauseam on here a few years back. I remember algosdoc had some very knowledgeable and beneficial insights

 

[Ducttape]

Take home points - if it is labeled as single dose, you are running a risk if you use it as multi dose and have an issue.

multidose - just draw it up with a new needle and syringe not in a room with a patient.