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Do agents used for epidural analgesia have antimicrobial properties?
J M Feldman1, K Chapin-Robertson, J Turner
1Department of Anesthesiology, Albert Einstein Medical Center, Philadelphia, PA 19141.
Regional Anesthesia
|January 1, 1994
Summary
Local anesthetics like lidocaine and bupivacaine showed reduced bacteria growth inhibition at lower concentrations. Opioids fentanyl and sufentanil did not inhibit bacterial growth, suggesting limited use in preventing common infections.
Area of Science:
- Microbiology
- Pharmacology
- Infectious Disease
Background:
- Local anesthetics exhibit antimicrobial properties, but effectiveness decreases with concentration.
- The antimicrobial effects of opioids on bacteria are largely uncharacterized.
Purpose of the Study:
- To evaluate the in vitro antibacterial activity of lidocaine and bupivacaine, alone and in combination with fentanyl or sufentanil.
- To determine if these agents inhibit bacterial growth at clinically relevant analgesic concentrations.
Main Methods:
- Bacteria pathogens were cultured on agar media with varying concentrations of lidocaine and bupivacaine.
- Combinations of bupivacaine with fentanyl or sufentanil were tested, alongside opioids alone.
- Bacterial growth was assessed after 24-hour incubation.
Main Results:
- Lidocaine and bupivacaine significantly inhibited bacterial growth across all tested concentrations (P < .0001).
- Growth inhibition was concentration-dependent, with reduced efficacy at lower anesthetic levels, particularly against Staphylococcus aureus.
- Fentanyl and sufentanil demonstrated no inhibitory effect on bacterial growth in culture.
Conclusions:
- The tested local anesthetics are unlikely to prevent common pathogen-related epidural-catheter infections due to diminished efficacy at reduced concentrations.
- Further research is needed to explore the potential of local anesthetics against less common pathogens in high-risk patients.