Preservative is a substance or a chemical that is added to

products to prevent decomposition by microbial growth or by
undesirable chemical changes

Parabens
• These compounds are added to local anesthetic preparations to provide
an antibacterial effect
• there is no “convincing evidence” in the literature of a neurotoxic effect
of these compounds
• Hodgson et al.7 concluded that “parabens are safe when administered
spinally in the small doses associated with preservative use
Metabisulfite
• Metabisulfite is added to epinephrine-containing local anesthetic
solutions as an antioxidant. The intended effect is to increase the
stability of the mixture and enhance shelf life
• these compounds are also included in many emergency drug
preparations such as epinephrine, procainamide, phenylephrine,
dopamine, dobutamine, an dexamethasone
• chronic IT administration of morphine with bisulfite and bupivacaine in
cancer patients with pain, associated with improved pain relief and
functional status of the patients.
• Laboratory studies and extensive clinical experience with morphine,
fentanyl, and sufentanil can reasonably assure the safety of limited
intrathecal doses of these drugs
Miller, 2020
Terima Kasih