ABSTRACT
Objective To evaluate the disinfect effects of glutaraldehyde, ortho-phthalaldehyde ( OPA ) and peracetic acid on gastroscopy disinfection. Methods Relevant literature from PubMed, Cochrane Library, web of science, Embase, CNKI, CBM, VIP were retrieved to collect the randomized controlled trials on disinfection by glutaraldehyde, OPA and peracetic acid on gastroscope. Literature was selected according to the inclusion and exclusion criteria. The RevMan 5. 3. 4. 0 statistic software was used to extract data and a meta-analysis was performed. Results A total of 18 RCT were included. There were significant differences in the disinfect effects between the OPA group and the glutaraldehyde group ( OR=2. 02, 95％CI:1. 88-1. 27, P<0. 00001), and between the peracetic acid group and the glutaraldehyde group ( OR = 2. 79, 95％CI:1. 52-5. 11, P = 0. 0009 ) . There were no significant differences in the disinfection effect between the OPA group and peracetic acid group ( OR=1. 30,95％CI:0. 62-2. 73, P=0. 49) . Conclusion The disinfect effects of OPA and peracetic acid are similar, which are superior to glutaraldehyde. Compared with OPA and glutaraldehyde, peracetic acid is a better choice considering its good disinfect effect and low cost.
ABSTRACT
Las reacciones anafilácticas intraoperatorias son impredecibles, infrecuentes y pueden poner en riesgo al paciente. Tienen una incidencia de 1/10 000 a 1/20 000 produciéndose en la mayoría de los casos por bloqueantes musculares, látex y antibióticos. No hay estadística de las reacciones alérgicas sistémicas durante otros procedimientos médicos. El estudio diagnóstico posterior a una reacción es complejo debiendo incluir toda la medicación utilizada en el procedimiento. En este estudio retrospectivo describimos 15 pacientes, de los cuales 10 tuvieron reacciones anafilácticas en un procedimiento quirúrgico, 2 en endoscopías y 1 en una ecografía transvaginal. Los dos pacientes restantes presentaron una reacción alérgica sistémica durante una ecografía transvaginal y un procedimiento odontológico. Estudiamos los pacientes con toda la medicación utilizada, incluimos látex y, eventualmente, los detergentes y desinfectantes, de haber sido empleados. Tres de las 10 cirugías no pudieron realizarse por desarrollarse la reacción durante la inducción anestésica, en cinco casos debieron interrumpirse y solo en dos se terminaron. Las reacciones posteriores a endoscopías fueron severas, requiriendo internación en terapia intensiva; las reacciones en ecografías transvaginales y procedimientos odontológicos fueron asistidas en emergencias. Los agentes causales en las cirugías incluyeron bloqueantes musculares, látex, cefalosporina, azul patente y ranitidina; en endoscopías el agente causal fue el orto-ftalaldehído (OPA), en las ecografías transvaginales el látex y en el procedimiento odontológico la amoxicilina. El objetivo de este artículo es describir la etiología de las reacciones alérgicas sistémicas y anafilácticas intraoperatorias y en procedimientos médicos, recalcando su gravedad y la necesidad de su identificación.
Anaphylaxis during anesthesia is an unpredictable, severe, and rare reaction. It has an incidence of 1/10 000 to 1/20 000 surgeries. In most series, the responsible drugs include neuromuscular blocking agents, latex, or antibiotics. The frequency and etiology of systemic allergic reactions in other medical procedures are largely unknown. The identification of responsible drugs of anaphylaxis is a complex task, requiring testing of all medications and substances used during surgery. We describe our experience in a retrospective study of 15 patients. Ten subjects developed anaphylaxis during surgery, two in endoscopic studies and one in a trans-vaginal ultrasound. The remaining two subjects, one in a trans-vaginal ultrasound and another during a dental procedure had a systemic allergic reaction. We studied all patients with all medications administered during the procedures, including latex and detergents and disinfectants. Three surgeries had to be suspended at induction of anesthesia, five were stopped incomplete and two were completed. Both patients that presented a reaction during endoscopy required intensive care unit admission and the rest were observed in a Hospital. The responsible drugs during surgery anaphylaxis were neuromuscular blocking agents, latex, patent blue, and ranitidine. Ortho-phthalaldehyde (OPA) was identified during endoscopic studies; latex was responsible in transvaginal ultrasounds; and amoxicillin in the dental procedure. The aim of the present article is to review our experience studying allergic systemic reactions and anaphylaxis during general anesthesia and medical procedures, emphasizing the severity of these reactions and the need for causative drug identification.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Echocardiography, Transesophageal/adverse effects , Endosonography/adverse effects , Endoscopy/adverse effects , Hypersensitivity/etiology , Anaphylaxis/etiology , Intraoperative Complications/etiology , Surgical Procedures, Operative/adverse effects , Retrospective StudiesABSTRACT
Objective To compare the durability and cost-effectiveness of slightly acidic electrolyzed oxidizing water(SAEOW),ortho-phthalaldehyde (OPA) and glutaraldehyde (GA) in two conditions,i.e.,continuous machine cleaning and continuous manual cleaning.Methods The maximal numbers of endoscopes which were disinfected by the three disinfectants at its minimal effective concentration,as well as the corresponding costs were compared.The cost-effectiveness of three disinfectants were evaluated with revenue-incremental cost analysis.Results The number of endoscopes disinfected by ortho-phthalaldehyde was larger than that by two other disinfectants,140 ± 2 by machine wash and 226 ± 1 by hand washing;followed by glutaral disinfectant,88 ± 2 and 108 ± 2 by machine wash and hand wash,respectively;slightly acidic electrolyzed oxidizing water disinfected the least endoscopes,34 ± 2 and 39 ± 1 by machine wash and hand wash.There were significant differences among these three disinfectants (all P ＜ 0.05).Compared with GA,one more Yuan invested to OPA yielded 2.24 yuan more under the condition of machine wash and 3.14 yuan more under the condition of hand wash.Compared with GA,one Yuan invested in SAEOW produced 47.14 yuan by machine wash and 45.6 Yuan by hand wash.Conclusion Under full workload,orthophthalaldehyde shows the best durability among the three disinfectants,while slightly acidic electrolyzed oxidizing water shows the highest economic benefit.
ABSTRACT
Objective Comparative study of the disinfection expense , turnover rate and the effect on health of ortho-phthalaldehyde and glutaraldehyde used for disinfection of bronchofiberscope , to provide the basis of the promoted application of domestic ortho -phthalaldehyde .Methods Based in turnover time of each bronchofiber-scope, the maxminal disinfection expense in month , the maxminal number of bronchofiberscope in month and the maxminal net value were compared with medical revenue in month .Two different disinfections are calculated .Ques-tionnaires about the effects were sent to twenty workers from the supply room involved in using two different disinfec -tion liquid, and the results were analyzed .Results The disinfection expenses of ortho -phthalaldehyde were higher than that of glutaraldehyde , but bronchofiberscope turnover rate increased by 50%, while medical net revenue in-creased by 40%.According to the questionnaires , the respiratory and conjunctival irritation of the workers were mi-nor, and the symptom of any skin irritation did not appear .Conclusion Although the expense increased , ortho-phthalaldehyde obviously improved the bronchofiberscope turnover rate and medical net revenue ,reduced the staff oc-cupational exposure and equipment residual effects on patients .Thus, ortho-phthalaldehyde is an efficient disinfect-ant that is worthy of being promoted in clinical practice .
ABSTRACT
OBJECTIVE To study the germicidal efficacy and germicidal mechanism of compound ortho-phthalaldehyde(OPA) against Bacillus subtilis var.niger spores.METHODS Suspension quantitative germicidal test was used to observe the germicidal efficacy of compound OPA against B.subtilis var.niger spores.The germicidal mechanism of compound OPA was studied in transudation of protein and DNA and ultra-microstructure.RESULTS The results showed that at(20?1)℃,the logarithm mean reduction was greater than 5.00,after B.subtilis var.niger spores had been exposed to compound OPA for 30min.Some protein leaked from B.subtilis var.niger spores treated with compound OPA for some time,but there wasn′t DNA.The ultrastructure showed that the shape was amorphic,the electronic density of the coat was unequal,the core leaned to one side or appeared the transmission area.CONCLUSIONS Compound OPA can effectively kill B.subtilis var.niger spores.Its mechanisms are that in accordance with benzolkonium bromide(Bromogeramine) the compound OPA can change the osmotic pressure of cell and increase cell permeability,then it can easily penetrate to their target sites within the cell.