The Risk of Infection Associated With Epidural Analgesia

Brooks, Kathy; Pasero, Chris; Hubbard, Lex; Coghlan, Raymond H.

doi:10.1086/647047

Cited by 13 publications

(14 citation statements)

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“…By minimizing the number of breaks in a closed system, the risk of contamination is decreased. 29 When an infusion solution is changed, precautions should be taken so as not to contaminate the infusion tubing and reservoir. This may include the use of a mask and sterile gloves; however, there are no universally accepted guidelines for this task and practices vary based on institutional or agency guidelines.…”

Section: Changing the Infusatementioning

confidence: 99%

A Review of Epidural Catheter-Related Infections

Hayek

Goomber

2012

Hospital Practice

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Spinal drug delivery is a generally safe and effective therapy for the treatment of both acute and chronic pain. However, it can be occasionally associated with significant complications, including neurologic injury, as a result of bleeding and infection in a confined space. This article focuses on risk factors for developing epidural catheter-related infections as well as strategies to minimize risks. Additionally, the diagnosis and management of epidural catheter-related infections, both superficial and deep, are discussed.

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Section: Changing the Infusatementioning

confidence: 99%

A Review of Epidural Catheter-Related Infections

Hayek

Goomber

2012

Hospital Practice

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“…Epidural analgesia in parturients is a rare cause of central nervous system infection with large survey studies showing a very low incidence of infection. [33][34][35][36][37] Indeed, one study suggested that repeated epidural anesthesia in the presence of infection might be safe! 38 For a Cesarean section in the setting of a fever, 55% of anesthesiologists would use spinal anesthesia for delivery, with 27% of UBAs and 41% of CBAs using general anesthesia.…”

Section: Fever and Epidural Analgesia And Anesthesiamentioning

confidence: 99%

Obstetric anesthesia practice in Canada

Breen

McNeil

Dierenfield

2000

Can J Anesth/J Can Anesth

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Purpose: To describe obstetric anesthesia in Canada as practiced in 1997: to identify practices at variance with the literature and the opinions of experts: and to identify questions for future research.Methods: In 1997, a detailed postal questionnaire asking about the practice of obstetric anesthesia was mailed to all 1,539 specialist anesthesiologist members of the Canadian Anaesthetists' Society residing in Canada. Nonresponders were mailed a second questionnaire three months later.Results: There were 865 completed questionnaires returned for analysis (56.2%). Of these, 522 anesthesiologists practiced obstetric anesthesia (60.3%). The data were subdivided into those from anesthesiologists with a full or part-time university based practice (40.1%) and those from a community based practice (59.9%). University based and community-based anesthesiologists have very similar patterns of practice. Specific areas where anesthesia practice was different from current recommendations included: (1) information provided when obtaining consent for labour epidural analgesia, (2) use of opioids and local anesthetics for initiation of epidural analgesia, (3) use of coagulation testing in preeclampsia, (4) the common use of cutting spinal needles, (5) use of neuraxial morphine and nonsteroidal anti-inflammatory agents after Cesarean deliveries, (6) optimal treatment of neuraxial opioid side effects, (7) when to insert an endotracheal tube for general anesthesia after delivery, and (8) withdrawing epidural catheters through epidural needles.Conclusions: This survey presents reference data on the practice of obstetric anesthesia in Canada in 1997. Anesthesiologists with university affiliation have very similar practices to those without university affiliations.Objectif: Décrire l'anesthésie obstétricale pratiquée au Canada en 1997; identifier les pratiques qui diffèrent des pratiques documentées et des opinions d'experts et proposer des sujets de recherches ultérieures.Méthode : En 1997, un questionnaire détaillé sur la pratique de l'anesthésie obstétricale a été posté aux 1 539 anesthésiologistes membres de la Société canadienne des anesthésiologistes résidant au Canada. Trois mois plus tard, un second questionnaire a été posté à ceux qui n'avaient pas encore répondu.Résultats : Il y a eu 865 questionnaires remplis et analysés (56,2 %). De ce nombre, 522 provenaient d'anesthé-siologistes pratiquant l'anesthésie obstétricale (60,3 %). Les données ont été subdivisées selon le lieu de pratique, en milieu universitaire à temps complet ou partiel (40,1 %) ou en d'autres centres (59,9 %). Les modèles de pratique étaient très similaires. Certaines activités spécifiques différaient des recommandations courantes : 1) l'information fournie pour obtenir le consentement à l'analgésie épidurale pendant le travail, 2) l'usage d'opioïdes et d'anesthésiques locaux pour amorcer l'analgésie épidurale, 3) l'utilisation d'épreuve de coagulation en préé-clampsie, 4) l'usage courant d'aiguilles rachidiennes tranchantes, 5) l'administration neuraxiale...

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“…6,8---10 The incidence of infection associated with epidural catheter ranges from 0.06% to 5.3% in studies with surgical patients and the rate of site-specific infections (meningitis, paraspinal and epidural abscess) ranges from 0 to 0.7%. 1,6,10,11 There are several mechanisms by which epidural catheter causes infection. First, infection may occur by contamination of the catheter emergence site or its lumen and spreads along its duct.…”

Section: Introductionmentioning

confidence: 99%