Analgesic-muscle relaxant infusion in back pain therapy – technological and clinical aspects

Authors: I. Murínová - 1 3;  A. Linhartová 1,4;  J. Muselík 5;  J. Cihlo 1,6;  L. Dvířková 1,7;  J. Gregorová 8;  K. Kroutilová 1,9;  K. Langmaierová 1,3,10;  L. Polášková 1,2;  J. Vedrová 1,11;  M. Vodička 1,12
Authors‘ workplace: Pracovní skupina pro ředění a podávání léčiv, Česká odborná společnost klinické farmacie ČLS JEP 1;  Oddělení klinické farmacie, Krajská zdravotní, a. s. – pracoviště Teplice 10;  Pracoviště klinické farmacie, Ústav hematologie a krevní transfuze, Praha 11;  Pracoviště klinické farmacie, Lékárna, Krajská nemocnice T. Bati, a. s., Zlín 12;  Oddělení klinické farmacie, ÚVN – VFN, Praha 2;  Ústav aplikované farmacie, Farmaceutická fakulta, MU, Brno 3;  Oddělení klinické farmacie, Lékárna, Fakultní Thomayerova nemocnice, Praha 4;  Ústav farmaceutické technologie, Farmaceutická fakulta, MU, Brno 5;  Lékárna Multiscan Pharma, s. r. o. – oddělení přípravy cytostatik, Pardubice 6;  Oddělení klinické farmacie, FN Plzeň-Bory 7;  Oddělení klinické farmacie, FN Bulovka, Praha 8;  Pracoviště klinické farmacie, Ústavní lékárna, MOÚ, Brno 9
Published in: Cesk Slov Neurol N 2021; 84(5): 465-471
Category: Original Paper
doi: 10.48095/cccsnn2021465


Aim: The aim was to clarify the constituents and the method of administration of analgesic-muscle relaxant infusions (AMIs) routinely used in clinical practice, to rationalise individual components in AMIs, and to evaluate the compatibility and stability of the most often used AMI components. Methods: In the form of a questionnaire survey, 15 randomly selected clinical departments were contacted to obtain an overview of the spectrum of AMIs used in the Czech Republic. The rationality of the composition of AMIs was evaluated based on an assessment of the pharmacological and pharmaceutical properties of the drugs and the evidence for their use in back pain therapy. Furthermore, a compatibility and stability study of the two most often used AMIs (mixture No. 1: trimecaine, metamizole, guaifenesin; mixture No. 2: trimecaine, metamizole, magnesium sulfate) was conducted. Results: A large number of different combinations of drugs was found to be used, most often from the group of analgesics, muscle relaxants, corticosteroids, and local anaesthetics. The composition of AMIs proved not to be always completely rational, both from a pharmacotherapeutic (efficacy, safety, evidence) and technological (compatibility, stability) point of view. The performed technological study then proved the compatibility and stability of the two most frequently used mixtures. Conclusions: The established use of AMIs has a number of significant shortcomings. Therefore, in most cases and for a variety of reasons, oral administration of drugs seems to be more appropriate for the treatment of back pain. Intravenous therapy could thus be reserved for specific situations.


infusion therapy – muscle relaxants – back pain – Analgesics – oral therapy – stability study


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