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Bacterial contamination of epidural needles after multiple skin passes
C Orlikowski1, P M Majedi, A D Keil
1Department of Anaesthesia, King Edward Memorial Hospital for Women, Bagot Road, Subiaco, WA 6008, Australia.
Background:
Infection and epidural abscess are important complications of epidural analgesia. Difficult insertion may be associated with an increased risk of bacterial contamination of the epidural needle or catheter.
Methods:
Bacterial contamination of epidural needles and trocars after difficult epidural insertion, defined as two or more skin passes, was assessed in 38 obstetric and ten gynaecological patients.
Results:
There was no bacterial growth on any of the 48 epidural needles or trocars despite the mean (range) insertion time being 20 (10-30) min and the number of insertion attempts being 3 (2-4).
Conclusions:
Difficult epidural insertion is not associated with an increased risk of needle contamination and is therefore an unlikely source of epidural infection.
Insights
Difficult epidural needle insertion does not increase bacterial contamination risk. This study found no bacterial growth on needles after challenging epidural placements, suggesting it
Area of Science:
- Anesthesiology
- Infectious Disease Prevention
- Medical Device Safety
Background:
- Epidural analgesia can lead to serious complications like infection and epidural abscess.
- Difficult epidural needle insertion may increase the risk of bacterial contamination.
Purpose of the Study:
- To assess bacterial contamination of epidural needles and trocars following difficult epidural insertion.
- To determine if difficult insertion increases infection risk.
Main Methods:
- Bacterial contamination of epidural needles/trocars was evaluated after difficult insertions (≥2 skin passes).
- The study included 38 obstetric and 10 gynecological patients.
- Insertion time and attempt number were recorded.
Main Results:
- No bacterial growth was detected on any of the 48 epidural needles or trocars.
- The mean insertion time was 20 minutes (range 10-30 min).
- The mean number of insertion attempts was 3 (range 2-4).
Conclusions:
- Difficult epidural insertion is not linked to increased needle contamination.
- Difficult insertion is unlikely to be a source of epidural infection.