How to Mix Marcaine for an On-Q Pump

Marcaine (bupivicaine) is one of many local anesthetics that can be used in the ON-Q® Pain Buster pump. However, according to Drugs.com, "Mixing Marcaine with other local anesthetics is not recommended because of insufficient data on the clinical use of such mixtures." Pain pumps are usually filled in the operating room or the hospital pharmacy.

Things You'll Need

• Work surface covered with sterile drape
• Vials of Marcaine solution of prescribed strength and other prescribed injectables (if any)
• 60 mL syringe
• 18-gauge needles
• 70% isopropyl alcohol (IPA) swabs, individually packaged
• Cleanroom garb: gloves, mask, lab coat/gown, cap, shoe covers
• Hospital-approved disinfectant

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Instructions

• 1

  Perform this procedure in a controlled environment while wearing standard cleanroom gear, including lab coat or surgical gown, mask, cap, shoe covers and gloves, and maintain aseptic techniques.

• 2

  Arrange supplies and equipment on the sterile work surface within easy reach so that minimum movement is needed. Have the prescription available nearby for easy reference without need for handling.

• 3

  Open an alcohol wipe packet, remove the wipe and clean the top of a vial of Marcaine.

• 4

  Connect an 18-gauge needle to a 60 mL syringe.

• 5

  Remove the needle cover and draw the syringe plunger to fill the barrel with air to the prescribed volume of Marcaine.

• 6

  Load the syringe with Marcaine. Insert the needle into the valve top. Holding the vial in one hand and the syringe in the other, raise both simultaneously to the vertical position and inject all air from the syringe into the vial (this raises the pressure in the vial and makes it easier to fill the syringe).

  Withdraw the needle slowly from the vial until the tip is well below the level of the liquid in the vial and pull slowly on the syringe plunger to fill the barrel to the prescribed level. Withdraw the needle from the vial. Raise the syringe to vertical and depress the plunger very gently until a scant drop of liquid appears at the tip (this removes any air bubbles). Verify volume and adjust as necessary. Replace the needle cover and lay the filled syringe down on the sterile work surface.

• 7

  Load the pump chamber. Remove the cap from the pump's fill port and lay it on the sterile work surface for later use. Remove the capped needle from the syringe. Connect the syringe securely to the fill port. Depress the syringe plunger until all of the contents are delivered into the pump.

• 8

  If elements other than Marcaine are prescribed, attach a new needle (to avoid cross-contamination of multidose vials) to the same syringe. Continue the filling procedure until the required volume is reached in the pump.

• 9

  Replace the fill port cap securely.

• 10

  Label the filled pump and hold at room temperature for 24 hours or at 2-8°C for 3 days. If for some reason the pump is not used by then, discard the pump.

• 11

  Return all unused supplies and equipment to storage. Discard disposable equipment, empty vials and trash appropriately.