Infection Related to Ultrasound-Guided Single-Injection Peripheral Nerve Blockade

Abstract

The use of ultrasound guidance has revolutionized regional anesthesia practice. Ultrasound equipment disinfection techniques vary between institutions. To date, there are no large data set publications or evidence-based guidelines that describe risk-reduction techniques for infectious complications related to the use of ultrasound guidance for peripheral nerve blockade. We retrospectively reviewed the medical charts of 7476 patients who received ultrasound-guided single-injection peripheral nerve blockade from October 2003 to August 2013 using our institution's low-level disinfection technique in combination with a sterile transparent film barrier dressing to cover the ultrasound transducer. No indications of block-related infection were found. We conclude that using a practical and efficient low-level disinfection technique and sterile barrier dressing results in an extremely low rate of block-related infection following ultrasound-guided single-injection peripheral nerve blockade.

Hygieneaspekte in der ultraschallgestützten Regionalanästhesie

“…Eine einzige Arbeit beschäftigt sich mit dem direkten Zusammenhang von Ultraschall, Regionalanästhesie und Injektionen. Alakkad et al untersuchten 7476 periphere Nervenblockadenineiner retrospektiven Analyse und beobachteten keine infektiösen Ereignisse [1]. Es ist wichtig zu erwähnen, dass bei diesen Blockaden sterile Ultraschallüberzüge verwendet wurden und somit eine wichtige Maßnahme zur Infektionsverbreitung gesetzt wurde.…”

State of the art opioid-sparing strategies for post-operative pain in adult surgical patients

“…More commonly, early transient postoperative neurologic symptoms are quite common but rarely result in long-term neurologic sequelae [122]. Infectious risks of single-injection techniques remain very low; however, cPNBs have been shown to be associated with a 0-1% risk of infection depending on the duration of catheter use and site [123,124]. More common site-specific risks include quadriceps weakness and falling for femoral nerve blocks, pneumothorax for brachial plexus and thoracic truncal blocks, and phrenic nerve blockade for some brachial plexus blocks.…”

Evaluation of Ultrasonography Probe Disinfection Habits in Peripheral and/or Central Regional Blocks Applied with Ultrasound Guidance

“…Alakkad et al, have reported that they did not encounter any block-associated infection in their study of 10-year hospital data. [15] It is reported that sterile probe coatings were used, a mixture of povidone iodine or 70% alcohol + 2% chlorine hexidine was used as a disinfectant, and sterile US gels were preferred in the study including 7476 patients records. In the study, it was stated that UGRA-related infection rates could be reduced considerably by using sterile probe coating methods with low-level disinfectants.…”