How do you prepare cold Balanced Salt Solution (BSS)?

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Last updated: June 14, 2025View editorial policy

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From the Guidelines

To prepare cold Balanced Salt Solution (BSS), dissolve the required salts in pre-heated water at 50-60°C to facilitate dissolution, then adjust the temperature to the desired cold state. When preparing BSS, it is essential to follow proper protocols to ensure the solution is sterile and isotonic. The composition of BSS includes specific concentrations of sodium chloride, potassium chloride, calcium chloride dihydrate, magnesium chloride hexahydrate, sodium bicarbonate, and sodium phosphate dibasic anhydrous, which should be dissolved in pharmaceutical-grade distilled water 1.

  • Key considerations in the preparation process include:
    • Pre-heating the water to 50-60°C may facilitate dissolution 1
    • Filling the flask to a maximum of ½ capacity to avoid spills and not exceeding 1 L per flask for mixing 1
    • Adjusting the pH to 7.4 using either dilute hydrochloric acid or sodium hydroxide
    • Filtering the solution through a 0.22-micron filter to ensure sterility
  • Once the solution is prepared, it should be refrigerated at 2-8°C to maintain its cold state, which is crucial for its use in ophthalmic procedures and tissue preservation, as it reduces cellular metabolism and extends tissue viability.
  • The specific salt concentrations in BSS are designed to mimic the electrolyte composition of human extracellular fluid, providing an isotonic environment that prevents cell damage from osmotic stress while the solution is in contact with tissues.

From the Research

Preparation of Cold Balanced Salt Solution (BSS)

To prepare cold BSS, the following steps can be considered:

  • The temperature of the BSS solution is crucial, with studies indicating that a temperature of around 2.7°C is effective in reducing post-surgery discomfort and inflammation 2, 3.
  • The BSS solution should be cooled to the desired temperature before use, with some studies suggesting that cooling the solution to a temperature of 2.7°C can be beneficial in preventing postoperative macular thickening and reducing anterior chamber flare, pain, and conjunctival hyperemia 2, 3.
  • It is essential to note that the preparation of cold BSS may vary depending on the specific application and the equipment available, with no specific guidelines provided in the available studies.

Considerations for Preparation

Some key considerations for preparing cold BSS include:

  • The solution should be sterile and free from contaminants to prevent infection and ensure safe use.
  • The temperature of the solution should be carefully controlled to achieve the desired cooling effect, with studies suggesting that a temperature of around 2.7°C is effective in reducing post-surgery discomfort and inflammation 2, 3.
  • The BSS solution should be used in accordance with the manufacturer's instructions and guidelines for use in specific medical procedures, such as phacoemulsification and cataract surgery 2, 3.

Available Evidence

The available evidence suggests that cold BSS can be effective in reducing post-surgery discomfort and inflammation, with studies indicating that a temperature of around 2.7°C can be beneficial in preventing postoperative macular thickening and reducing anterior chamber flare, pain, and conjunctival hyperemia 2, 3. However, the preparation of cold BSS may vary depending on the specific application and the equipment available, with no specific guidelines provided in the available studies.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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