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From: Date: 03 Jun 2006 Time: 12:46:05 +1100 Remote Name: 60.226.181.89 Comments: There are of course some premixed bags around eg local anaesthetic with fentanyl for epidural infusions. The arguments against pre-mixed bags are: 1. Inflexibility: the drug ratio is fixed and the Anaesthetist cannot vary this to suit individual circumstances. This is I think the biggest issue. For example, may need to use less of one component because of preop admin of similar drug (eg less fentanyl if morphine given in ED). The doses of one component may be different in different clinical circumstances and cannot alter it independently of the other compoonent(s). 2. Drug reactions - (as mentioned in previous post) - problem is one of sorting out which component is the cause: However, the usual situation is to give drugs closely following one another at induction so the same problem is there in any case. The problem is subsequently solved in most cases by appropriate allergy testing after the event. 3. Economic: eg too small a demand so no profit for the companies involved; or not used much so much discarding of product when expiry date reached. The demend in the "market" ultimately sorts this out.