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Extradural anaesthesia for repeated surgical treatment in the presence of infection
K B Jakobsen1, M K Christensen, P S Carlsson
1Department of Anaesthesia, Aarhus University Hospital, Denmark.
Abstract:
The use of extradural catheters in patients with systemic or localized infection is controversial. The catheter may act as a focus for secondary infection resulting in an extradural abscess. in this study we have examined the use of extradural catheters for anaesthesia over the past 7 yr in patients with localized infections. The records of 69 patients were reviewed and patients interviewed (letter/phone). These patients had a total of 120 extradural catheters placed and received, on average, four anaesthetics, with the extradural catheter remaining in place for a mean of 9 days. On 12 occasions (eight patients) the catheter was removed because of signs or symptoms of local infection. Specific antibiotic therapy was not initiated, but ongoing therapy was continued. A single case of spondylitis was the only serious complication found but was not related to the extradural technique. We conclude that extradural anaesthesia for patients who require repeated surgical treatments for abscesses or infected wound is a relatively safe procedure.
Insights
Extradural catheters can be safely used for anesthesia in patients with localized infections, even with repeated procedures. This study found minimal serious complications, suggesting the technique is relatively safe for managing abscesses and infected wounds.
Area of Science:
- Anesthesiology
- Infectious Diseases
- Neurosurgery
Background:
- The use of extradural catheters in patients with infections is debated due to potential secondary infection risks.
- This study investigates the safety of extradural catheters in patients with localized infections requiring repeated anesthesia.
Observation:
- Reviewed records of 69 patients with 120 extradural catheters placed over 7 years.
- Catheters remained in place for an average of 9 days, with some removed due to local infection signs.
- No specific antibiotic therapy was initiated for infection during catheterization.
Findings:
- A single case of spondylitis was observed, but it was unrelated to the extradural technique.
- 12 instances (8 patients) required catheter removal due to local infection signs.
- No secondary extradural abscesses were reported in this cohort.
Implications:
- Extradural anesthesia appears to be a relatively safe procedure for patients needing repeated surgical treatments for abscesses or infected wounds.
- The findings challenge the absolute contraindication of extradural catheters in localized infection settings.
- Further research could refine protocols for managing extradural catheters in infected patients.