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Epidural catheter reconnection. Safe and unsafe practice
P B Langevin1, N Gravenstein, S O Langevin
1Department of Anesthesiology, University of Florida College of Medicine, Gainesville 32610-0254, USA.
Anesthesiology
|October 1, 1996
Summary
Disconnected epidural catheters may remain sterile internally for 8 hours if fluid is static. Cleaning the exterior and reconnecting at this sterile site prevents bacterial contamination.
Area of Science:
- Infectious Disease
- Medical Device Safety
- Epidural Anesthesia
Background:
- Epidural catheters are susceptible to contamination.
- Reconnecting disconnected catheters poses a risk of infection.
Purpose of the Study:
- To determine if disconnected epidural catheters can be safely reconnected.
- To assess the potential for internal sterility in disconnected catheters.
Main Methods:
- An in vitro model using epidural catheters was developed.
- Catheters were filled with broth or saline with fentanyl and inoculated with bacteria.
- Bacteria dissemination was studied under static and dynamic fluid conditions, and in vertical/horizontal positions.
- Exterior decontamination and reconnection procedures were evaluated.
Main Results:
- Static fluid in catheters prevented bacterial detection beyond 13 inches (BHI) or 8 inches (fentanyl) for 8 hours.
- Vertical positioning did not affect bacterial spread.
- Fluid displacement of 13 inches led to bacterial contamination at the catheter's distal end.
- No bacteria were cultured from reconnected catheters after exterior decontamination.
Conclusions:
- A sterile internal segment may exist in disconnected epidural catheters for at least 8 hours under static fluid conditions.
- Adequate exterior cleaning allows for safe reconnection at the sterile site, preventing bacterial entry.