Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942011000400013
Brazilian Journal of Anesthesiology
Miscellaneous

Ampolas de vidro: riscos e benefícios

Glass ampoules: risks and benefits

Antônio Roberto Carraretto; Erick Freitas Curi; Carlos Eduardo David de Almeida; Roberta Eleni Monteiro Abatti

http://dx.doi.org/10.1590/S0034-70942011000400013 Braz J Anesthesiol, vol.61, n4, p.517-521, 2011
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Resumo

JUSTIFICATIVAS E OBJETIVOS: Ampolas de vidro têm sido amplamente utilizadas no acondicionamento de fármacos. O vidro apresenta importantes características que lhe conferem o uso amplo na fabricação de recipientes para o acondicionamento de fármacos e outras substâncias estéreis. No entanto, a contaminação das soluções com micropartículas de vidro durante a abertura, a presença de metais, acidentes pérfuro-cortantes e contaminações biológicas justificam a necessidade de materiais educativos que orientem a manipulação dessas ampolas. CONTEÚDO: As micropartículas de vidro geradas na abertura das ampolas podem ser aspiradas e injetadas nas mais diversas vias, assim como os metais que contaminaram o conteúdo das ampolas. As contaminações exógenas por vidros e metais podem alcançar diversos sítios no organismo. Desencadeiam-se reações orgânicas que podem dar origem a lesões. Abrir ampolas pode expor o profissional ao risco de lesões pérfuro-cortantes. Essas lesões aumentam o risco biológico em razão de serem a porta de entrada para vírus e bactérias. Sistemas de abertura de ampolas (VIBRAC E OPC) foram desenvolvidos para reduzir a incidência de tais acidentes. Materiais alternativos ao vidro podem representar uma estratégia interessante para aumentar a segurança. O uso de seringas esterilizadas pré-preparadas pelo fabricante pode consistir em uma evolução em relação à segurança. CONCLUSÃO: O treinamento da equipe e o esclarecimento por parte da indústria farmacêutica quanto ao uso de ampolas mostram-se fundamentais na profilaxia de acidentes e contaminações. Ainda é necessário descobrir novos sistemas de abertura de ampolas de forma mais segura. Não menos importante será a busca de materiais seguros que sirvam de alternativa ao uso do vidro.

Palavras-chave

ANESTESIOLOGIA, ANESTESIOLOGIA, EQUIPAMENTOS

Abstract

BACKGROUND AND OBJECTIVE: Glass ampoules have been widely used in packaging injection drugs. Glass has important characteristics that allow it to be widely used in fabrication of recipients for drugs and other sterile substances. However, contamination of solutions with glass microparticles on breaking open glass ampoules, the presence of metals, percutaneous injury, and biological contamination justify the need of educational materials to orient the manipulation of ampoules. CONTENTS: Glass microparticles generated in the snap-opening of ampoules, as well as metals that contaminate their contents can be aspirated and injected through several routes. Exogenous contaminations by glass and metals can reach several sites in the organism. They trigger organic reactions that may give rise to injuries. Opening ampoules can expose professionals to the risk of percutaneous injuries. These lesions increase the biological risk as they are the gateway for viruses and bacteria. Ampoules opening systems (VIBRAC and OPC) have been developed to reduce the incidence of such accidents. Alternative materials to glass may represent an interesting strategy to increase safety. The use of prefilled syringes may represent an evolution regarding safety. CONCLUSIONS: Team training and information provided by the pharmaceutical industry on the use of ampoules are fundamental in the prophylaxis of accidents and contaminations. The search for safer materials to replace glass is also important.

Keywords

Disposable Equipment, Glass, Anesthesiology, Education, Education, Education

References

Shelby JE. Introduction to glass science and technology. 2005:72-108.

Carbone-Traber KB, Shanks CA. Glass particle contamination in single-dose ampules. Anesth Analg. 1986;65:1361-1363.

Pavanetto F, Genta I, Conti B. Aluminium, cadmium and lead in large volume parenterals: contamination levels and sources. Int J Pharmaceutics. 1989;54:143-148.

Garvan JM, Gunner BW. The harmful effects of particles in intravenous fluids. Med J Aust. 1964;2:1-6.

Bohrer D, Nascimento PC, Binotto R. Investigação sobre a origem do alumínio em soluções de nutrição parenteral. Rev Bras Nutr Clin. 2003;18:47-56.

Russell SH. Glass ampules: another approach. Anesth Analg. 1994;78.

Waller DG, George CF. Ampoules, infusions and filters. Br Med J (Clin Res Ed). 1986;292:714-715.

Ben-David B, Gaitini L. The routine wearing of gloves: impact on the frequency of needlestick and percutaneous injury and on surface contamination in the operating room. Anesth Analg. 1996;83:623-628.

Hemingway CJ, Malhotra S, Almeida M. The effect of alcohol swabs and filter straws on reducing contamination of glass ampoules used for neuroaxial injections. Anaesthesia. 2007;62:286-288.

, . Evite acidentes em abertura de ampolas. Revista COREN - SP. 2007.

Stewart PC. A persistent problem with glass ampoules. Anaesthesia. 1997;52:509-510.

Gallacher BP. Glass ampules. Anesth Analg. 1993;77:399-400.

Parker MR. The use of protective gloves, the incidence of ampoule injury and the prevalence of hand laceration amongst anaesthetic personnel. Anaesthesia. 1995;50:726-729.

Tiefenthaler W, Gimpl S, Wechselberger G. Touch sensitivity with sterile standard surgical gloves and single-use protective gloves. Anaesthesia. 2006;61:959-961.

Kristensen MS, Sloth E, Jensen TK. Relationship between anesthetic procedure and contact of anesthesia personnel with patient body fluids. Anesthesiology. 1990;73:619-624.

Weenig CS. A better, safer, an inexpensive way to open glass ampules. Anesthesiology. 1998;88.

Mano EB. Introdução aos Polímeros. 1985.

Ball D, Tisocki K. PVC bags considerably reduce availability of diazepam. Cent Afr J Med. 1999;45.

Treleano A, Wolz G, Brandsch R. Investigation into the sorption of nitroglycerin and diazepam into PVC tubes and alternative tubes materials during application. Int J Pharm. 2009;369:30-37.

De Muynck C, Colardyn F, Remon JP. Influence of intravenous administration set composition on the sorption of isosorbide dinitrato. J Pharm Pharmacol. 1991;43:601-604.

Martens HJ, De Goede PN, Van Loenen AC. Sorption of various drugs in polyvinyl chloride, glass, and polyethylene: lined infusion containers. Am J Hosp Pharm. 1990;47:369-373.

Longfield R, Longfield J, Smith LP. Multidos medication vial sterility: an in-use study and a review of the literature. Infect Control. 1984;5:165-169.

Schubert A, Hyams KC, Longfield RN. Sterility of anesthetic multiple-dose vials after opening. Anesthesiology. 1985;62:634-636.

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