title: Efficacy of spray disinfection with a 2-propanol and benzalkonium chloride containing solution before epidural catheter insertion--a prospective, randomized, clinical trial.
abstract: BACKGROUND
  Skin disinfection before neuroaxial blockade procedures is usually obtained with sterile swabs impregnated in disinfectant. Spray disinfection is also an option which is frequently used in minor invasive procedures. The purpose of our study was to compare the efficacy of conventional swab disinfection with spray disinfection prior to epidural catheterization.
  
  
  METHODS
  Seventy patients who requested epidural analgesia were randomly selected. The first group (n=35) received disinfection with swabs (SW) containing 2-propanol and benzalkonium chloride. The other 35 patients received spray (SP) disinfection with the same solution. Three microbiological cultures were obtained: one culture prior to skin disinfection, a second immediately after disinfection and a third from the tip of the epidural catheter upon removal.
  
  
  RESULTS
  One patient in the SW group had a positive skin culture immediately after the disinfection with a very low number of colony forming units. The other skin culture specimens were all sterile in both groups. The colonization rate of catheters was not statistically different between the groups at removal.
  
  
  CONCLUSIONS
  In this study, spray disinfection was equally efficacious compared with the conventional skin disinfectant technique. Our results support the routine use of this simple and cheap alternative method of skin disinfection before epidural anaesthesia.
authors.affiliation: Department of Anaesthesiology and Intensive Care, University of Pécs, Hungary. drdebrecenig@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Debreceni
authors.forename: R
authors.initials: R
authors.lastname: Meggyesi
authors.forename: G
authors.initials: G
authors.lastname: Mestyán
mesh_terms: D019840:2-Propanol / Q000008:administration & dosage*; D000279:Administration, Cutaneous; D000336:Aerosols; D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001548:Benzalkonium Compounds / Q000008:administration & dosage*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods; D003428:Cross Infection / Q000517:prevention & control; D004203:Disinfection / Q000379:methods*; D004866:Equipment Contamination / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000382:microbiology
chemical_list: D000336:Aerosols; D000891:Anti-Infective Agents, Local; D001548:Benzalkonium Compounds; D019840:2-Propanol