Heat sterilization of all local anesthetic drugs and equipment is mandatory but is not being generally practiced. A survey of the techniques observed in using local anesthetic drugs showed that only 33 out of 101 hospitals were autoclaving the solutions before use. The remaining 68 hospitals depended on cold sterilization, the immersion of the ampul, vial, or bottle in a germicidal solution which acts upon the outside but not on the contents. Experience with 17,368 regional block procedures over a 54-month period has led the authors to conclude that a careful technique which includes the autoclaving of the anesthetic in its container is mandatory. The procedure here described is based on the demonstration that the local anesthetics most commonly used can be autoclaved for 30 minutes at 255 to 260 F. and 18 to 20 lb. of pressure (124 to 127 C and 1.22 to 1.36 atmospheres above ambient pressure) without significant loss of potency. This reduces the danger of bacterial contamination and simplifies both the preparation of regional block trays and the execution of regional block anesthesia.
Bridenbaugh LD, Moore DC. IS HEAT STERILIZATION OF LOCAL ANESTHETIC DRUGS A NECESSITY? JAMA. 1958;168(10):1334–1337. doi:10.1001/jama.1958.03000100036008
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