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Infusate contamination in regional anesthesia: what every anesthesiologist should know
Stephen Head1, F Kayser Enneking
1Department of Anesthesiology, Saint Paul's Hospital, and Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.
Anesthesia and Analgesia
|September 23, 2008
Summary
Contaminated infusate poses a risk for infection during regional anesthesia, particularly with home-infused medications. Adhering to sterile compounding guidelines and understanding infusate "hang-time" are crucial for patient safety.
Area of Science:
- Anesthesiology
- Infectious Disease
- Pharmaceutical Compounding
Background:
- Infection is a serious complication of regional anesthesia.
- Contaminated infusate is an underreported cause of infection, especially with home-use perineural catheters.
- Lack of national guidelines on infusate hang-time is a concern.
Purpose of the Study:
- To review literature on contaminated infusate causing infection in regional anesthesia.
- To discuss strategies for preventing infusate contamination.
- To explore the implications of USP Chapter 797 for anesthesiologists.
Main Methods:
- Literature review of contaminated infusate in regional anesthesia.
- Analysis of sterile compounding practices and hang-time.
- Examination of United States Pharmacopeia (USP) Chapter 797 guidelines.
Main Results:
- Contaminated infusate can lead to significant patient morbidity.
- There are no established national guidelines for regional anesthesia infusate hang-time in the US.
- USP Chapter 797 provides guidelines for sterile compounding of infusions.
Conclusions:
- Minimizing infusate contamination is vital for preventing infections associated with regional anesthesia.
- Anesthesiologists must be aware of and implement sterile compounding practices.
- Understanding and applying USP Chapter 797 is essential for safe anesthetic practice.
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