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Updated: Jun 21, 2026
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Bacterial contamination in solution aspirated from non-sterile packaged fentanyl ampoules: a laboratory study
S Merriman1, M J Paech, A D Keil
1Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital, Subiaco, Western Australia, Australia.
Abstract:
Iatrogenic meningitis is a rare complication of spinal anaesthesia. It is mandatory to use a technique which minimises the risk of introducing bacteria into the subarachnoid space. Currently available fentanyl ampoules require a careful drawing-up technique, as the outside of the ampoule is not sterile and there is potential to contaminate the contents in the drawing-up process. We designed a pilot laboratory study to determine the extent of bacterial contamination of fentanyl solutions drawn up from non-sterile packaged glass fentanyl ampoules using three different methods: aspirating through a 5 microm filter needle only, aspirating through a 5 microm filter needle after swabbing the neck of the ampoule with isopropyl alcohol and aspirating through an antibacterial filter in addition to the 5 microm filter needle. Ten anaesthetists used each method once, in randomised order to draw up solution from three different fentanyl ampoules. Samples underwent bacterial culture in blood agar and enrichment broth for 48 hours. No significant growth was seen in any sample. This pilot study did not identify any bacterial contamination of fentanyl solution irrespective of which of the three methods for aspiration was used.
Insights
This study investigated bacterial contamination when drawing fentanyl from glass ampoules. No significant contamination was found with any of the three tested aspiration methods, suggesting current techniques may be safe.
Area of Science:
- Anesthesiology
- Infectious Disease Prevention
- Pharmaceutical Compounding
Background:
- Iatrogenic meningitis is a rare but serious risk associated with spinal anesthesia.
- Non-sterile packaging of fentanyl ampoules poses a potential risk of bacterial contamination during preparation.
- Minimizing bacterial introduction into the subarachnoid space is critical for patient safety.
Purpose of the Study:
- To evaluate the extent of bacterial contamination in fentanyl solutions prepared from non-sterile glass ampoules.
- To compare the efficacy of three different aspiration techniques in preventing contamination.
Main Methods:
- A pilot laboratory study involving ten anesthesiologists.
- Three aspiration methods were tested: filter needle only, filter needle with alcohol swab, and filter needle with antibacterial filter.
- Fentanyl solutions were cultured for bacterial growth over 48 hours.
Main Results:
- No significant bacterial growth was detected in any of the tested fentanyl solution samples.
- Bacterial contamination was not identified regardless of the aspiration method employed.
Conclusions:
- This pilot study did not find evidence of bacterial contamination in fentanyl solutions prepared using the tested methods.
- The findings suggest that current techniques for drawing fentanyl from glass ampoules may be adequate in preventing contamination.
