Sterilization of Anesthesia Apparatus

Abstract

THE importance of sterilization of anesthesia equipment and the relationship between contaminated equipment and subsequent infection has not been established.It has been recommended that since anesthesia equipment is exposed to a heavily contaminated area of the body meticulous care should be exercised in the handling and sterilization of apparatus.1 Other workers, however, have either failed to detect significant contamination in a considerable part of the apparatus2 or have concluded that it was unlikely that cross-infection would occur.3-5 Sterilization of anesthesia equipment presents a rather difficult problem. Although certain items can apparently be sterilized by satisfactory techniques, bulky rubber items do not lend themselves to these techniques, and, in addition, must be processed in considerable quantity to meet the demands of a busy operating schedule. Germicides which are effective against certain organisms under certain conditions may be unsatisfactory under other conditions. Chemicals which have been found to be good bactericidal agents may be unsatisfactory because they are corrosive. This study was undertaken to determine the extent and character of contamination of anesthe¬ sia equipment, and to determine the effectiveness of a new germicide, buffered glutaraldehyde.8 Method Face masks, breathing tubes, rebreathing bags, endotracheal tubes, and Y connectors used in anes¬ thesia for operations in two wings of the operating suite were cultured after use and again after clean¬ ing with one of the following routines.Routine A.-Face masks, breathing tubes, and rebreathing bags were thoroughly washed in hexachlorophene and water, and connectors and endo¬ tracheal tubes were cleaned by brushing with hexachlorophene and water. All items were then thoroughly rinsed and soaked in 70% ethyl alcohol for 20 minutes.Routine B.-The above routine of cleaning with hexachlorophene followed by rinsing was carried out, and then all items were soaked in a solution of buffered glutaraldhyde for ten minutes.Equipment used for operations in one wing of the operating suite was subjected to routine A and that of the other wing was subjected to routine B on any given day. On alternate days the order of cleaning was reversed. Equipment used in 100 op¬ erations was selected for the testing of each of the routines.Representative items of anesthesia equipment were selected. In the course of the experiment 100 samples were taken from face masks, 100 from breathing bags, and 100 from Y connectors, and 200 were taken from rebreathing tubes (since there are two tubes in each set) for each of the cleaning routines. The samples were taken after use and again after employing one of the cleaning routines. Since endotracheal techniques were not employed in all of the operations, fewer endotracheal tubes were available for the test.Sample equipment from five additional cases was processed with cleaning routine B, cultured, and stored in plastic bags previously sterilized with ethylene-oxide. At intervals of 6, 30, 54, 78, and 102 hour...