How should we handle epidural solutions? One view

Langevin, Paul

doi:10.1053/rapm.2000.5660

Cited by 4 publications

(2 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, about one third of respondents failed to answer this question fully, indicating that many lack such a protocol. Nevertheless, the majority favoured (for a brief period of disconnection) cleaning with antiseptic, drying, cutting off the proximal portion with a sterile instrument and then re-connecting, as suggested by Langevin et al [6]. Only one unit agreed with considering the position of the meniscus, which was also suggested by Langevin et al [6].…”

Section: Discussionmentioning

confidence: 93%

A national survey of prevention of infection in obstetric central neuraxial blockade in the UK

McKenzie

Darragh

2011

Anaesthesia

View full text Add to dashboard Cite

SummaryWe conducted a postal survey of all consultant-led UK obstetric anaesthetic units in August 2009, to assess the standard of aseptic technique used for neuraxial blocks. One hundred and sixty-four units responded giving a response rate of 76%; 93% of units (149 ⁄ 160) follow recommended precautions and attach a bacterial micropore filter to the epidural catheter. Epidural top-ups are provided by 72% (116 ⁄ 162) of units, with about two thirds using premixed solutions (of local anaesthetic with opioid) in a variety of ways: 51% (57 ⁄ 111) via a continuous infusion pump; 47% (52 ⁄ 111) by a prefilled syringe; and 23% (25 ⁄ 111) by multiple use of a premixed bag of solution. For spinals, 91% of units (149 ⁄ 164) add diamorphine: of these 85% (126 ⁄ 149) draw the diamorphine from non-sterile-wrapped ampoules. If required to draw opioid from a nonsterile-wrapped ampoule, 86% (119 ⁄ 138) of units use a micropore filter and 21% (29 ⁄ 138) wipe the ampoule neck with an alcohol swab. Although sepsis secondary to neuraxial block in obstetric practice is uncommon (declared by 8.5% of units over an unspecified period of time), there is scope for further improvement. In January 2009, the Royal College of Anaesthetists published the National Audit Project (NAP) 3 Report [4], with a chapter on complications after neuraxial block in obstetric practice, which included infection. Subsequent learning points and recommendations were stated.The aim of this survey was to ascertain the standard of aseptic practice in the UK, with reference to these national guidelines and recommendations. MethodsData were collected from a questionnaire sent, together with a covering letter, to the lead obstetric anaesthetist in 221 maternity units in the UK. Approval for the survey was obtained from the Obstetric Anaesthetists' Association's Audit Subcommittee, which provided postal details. In the covering letter, each lead obstetric anaesthetist was asked to complete the questionnaire, commenting on the current practice in his or her unit. The questionnaire was designed to assess compliance with the current recommended good practice. The lead clinicians were asked to tick 'yes' or 'no' to questions and provide a few words of comment, where appropriate, with regard to practice in their maternity units. There were five sections of the questionnaire: Anaesthesia, 2011Anaesthesia, , 66, pages 497-502 doi:10.1111Anaesthesia, /j.1365Anaesthesia, -2044Anaesthesia, .2011.06705. x ................................................................................................................................................................................................................ 497facilities and practice in setting up epidural analgesia in the labour suite; management of epidural catheter disconnection; method of administering the epidural drugs, in particular the source of premixed epidural local anaesthetic with opioid and the precautions taken; the precautions taken with administration of spinal opioids; and lastly, an invitation to c...

show abstract

Section: Discussionmentioning

confidence: 93%

A national survey of prevention of infection in obstetric central neuraxial blockade in the UK

McKenzie

Darragh

2011

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…In case of disconnecting accidentally the first bacteria filter of the tandem circuit, the catheter was removed if possible. If it was not possible to remove the catheter, the catheter was disinfected thoroughly with an alcohol-containing antiseptic and dried according to a recommendation by Langevin [18]. Thus the proximal catheter end was cut off with a sterile instrument and then reconnected.…”

Section: Bacteria Filter Managementmentioning

confidence: 99%

Specific Prevention Against Infection of Local Catheters in Postoperative Pain Management

Hausmann¹

2016

J Anesth Clin Res

View full text Add to dashboard Cite

Background: The guideline for postoperative pain management therapy recommends several obligate measures and permissive provisions keeping catheters hygienic. An organized Pain Nurse is generally regarded as convenient. But some recommendations are still discussed. The guideline is based on only few large studies and the number of catheter-related infections differs from technique and risk profile. However, all recommendations for improvement have to be compared with the guideline. This prospective study was initiated to investigate the influence of catheter fixing, the frequency of changing dressings and the use of bacterium-filters on the rate of inflammation and infection.

show abstract

Residual neurological deficit after central neuraxial blocks

Sagadai

Panchagnula

Sundararajan

et al. 2012

Trends in Anaesthesia and Critical Care

View full text Add to dashboard Cite

How should we handle epidural solutions? One view

Abstract: Regional Anesthesia and Pain Medicine 25 (2000) 343-346. doi:10.1053/rapm.2000.5660Received by publisher: 0000-01-01Harvest Date: 2016-01-04 12:23:32DOI: 10.1053/rapm.2000.5660Page Range: 343-34

Cited by 4 publications

References 22 publications

A national survey of prevention of infection in obstetric central neuraxial blockade in the UK

A national survey of prevention of infection in obstetric central neuraxial blockade in the UK

Specific Prevention Against Infection of Local Catheters in Postoperative Pain Management

Residual neurological deficit after central neuraxial blocks

Contact Info

Product

Resources

About