Abstract
ABSTRACTObjective To compare sterility and microbial (bacteria and fungi) load in the outer part of hyperbaric bupivacaine (Neocaína®) in ampoule and bupivacaine in vial, in conventional and sterile pack formulations.Methods The sterile packs were divided into two groups: G1 (n=16) with ampoules and G2 (n=16) with vials. Conventional formulations were divided into two groups, being G3 (n=16) with ampoules and G4 (n=16) with vials. The ampoules and vials were opened and had their content drawn. The empty bottles were then placed in sterile plastic bags and sent for analysis of microbial load (bacteria and fungi) and sterility testing. Data were analyzed using the χ2 test with Yates correction, and 95% confidence interval.Results G1 and G2 showed no bacterial growth when compared to conventional groups (p<0.001). The most common agent in conventional microbiological samples was Staphylococcus aureus. There was no fungal growth in both groups.Conclusion The use of (sterile pack) reduces the microbial load of bottles, and would decrease the chance of exposure to potential contamination of the anesthetic solution.
Highlights
In the past years, modern medicine has used spinal anesthesia in many situations
Several case reports suggested the microorganisms of the patient’s or anesthesiologist’s microbiota can be directly inoculated when the needle or the catheter is inserted in these spaces, or when the anesthetic vial solutions are administered to patients, and the outer part of vials is not sterile.[6]. Many investigators collected cultures of needles, syringes and tubes used to administer regional anesthesia, aiming to check when these items become contaminated for use and, may be a source of infection
There may be a hematogenous dissemination of a distant source of infection, and contamination of the subarachnoid space occurs with blood flow during puncture.[10] the infusion of contaminated substances was the cause in a few cases, and some of them were fatal.[10]. The etiologic spectrum of meningitis associated to regional anesthesia is broad, including viridans group Streptococcus, other species of Streptococcus, Staphylococcus aureus, Pseudomonas spp., Enterococcus faecalis, Corynebacterium, Acinetobacter and even Aspergillus.[11]
Summary
Modern medicine has used spinal (peridural, subarachnoid or dual block) anesthesia in many situations It is used primarily in obstetrics, gynecology and lower limb surgeries, as well as in treatment of acute and chronic postoperative pain.[1] this technique might present complications, including some severe events, such as traumatic nerve lesions, peridural hematomas, infections like peridural and paravertebral abscess, and acute bacterial meningitis.[2,3,4,5]. There may be a hematogenous dissemination of a distant source of infection, and contamination of the subarachnoid space occurs with blood flow during puncture.[10] the infusion of contaminated substances was the cause in a few cases, and some of them were fatal.[10] The etiologic spectrum of meningitis associated to regional anesthesia is broad, including viridans group Streptococcus, other species of Streptococcus, Staphylococcus aureus, Pseudomonas spp., Enterococcus faecalis, Corynebacterium, Acinetobacter and even Aspergillus.[11]
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