• J Clin Anesth · Aug 2019

    Observational Study

    Microbial stability of syringes of anesthetic drugs prepared in the operating room.

    • Scott Segal, Antonius Gunawan, Douglas H McLaughlin, and Elizabeth Palavecino.
    • Department of Anesthesiology, Wake Forest School of Medicine, 1 Medical Center Blvd., Winston-Salem, NC 27157, United States of America. Electronic address: bsegal@wakehealth.edu.
    • J Clin Anesth. 2019 Aug 1; 55: 20-23.

    Study ObjectiveTo determine whether microbial contamination of anesthesia syringes prepared in the operating room (OR) become contaminated in a time-dependent fashion.DesignObservational.SettingOperating suite in a major university hospital.PatientsNone (in vitro study). 400 syringes were studied for microbial contamination.InterventionsSyringes prepared in the OR by anesthesia personnel were sampled at 1, 2, 3, or 4 h in a sterile fashion and sent to the microbiology laboratory for quantitative culture of any bacteria.MeasurementsColony forming units (CFU) per mL of drug were calculated and any identified positive cultures were identified by Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry. Logistic regression was used to test the effect of time since preparation on prevalence of positive culture, as was the effect of number of accesses of the syringe and identity of the drug.Main ResultsOverall, 9/400 (2.25%) syringes were positive for bacteria. The median (interquartile range [IQR]) concentration of bacteria among positive cultures was 100 (100,100) CFU. All cultured species were generally nonpathogenic common contaminants. There was no effect of time since preparation, number of accesses of the syringe at the time of sampling, or drug identity (propofol vs. other).ConclusionsContamination of anesthesia syringes is uncommon and occurs at a low overall concentration of bacteria. Contamination does not appear to be time related, and thus calls into question the reasonableness of USP Chapter 797's one-hour requirement.Copyright © 2018 Elsevier Inc. All rights reserved.

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