Neurological infections after neuraxial anesthesia.
Infection is the commonest cause of serious neurologic sequelae of neuraxial anesthesia. The incidence depends on operator skill and patient population. Meningitis, a complication of dural puncture, is usually caused by viridans streptococci. The risk factors are dural puncture during labor, no mask and poor aseptic technique, vaginal infection and bacteremia. Epidural abscess is a complication of epidural catheterization, route of entry the catheter track and the organism usually the staphylococcus. Principal risk factors are prolonged catheterization, poor aseptic technique and traumatic insertion. Prevention includes wearing a mask, using a full sterile technique, avoiding prolonged catheterization and prescribing antibiotics in a high-risk situation.
Reynolds
Felicity
F
Department of Anaesthetics, St Thomas's Hospital, London, UK. felicity.reynolds@btinternet.com
D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D020802:Epidural Abscess / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D009422:Nervous System Diseases / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D011183:Postoperative Complications / Q000188:drug therapy / Q000382:microbiology; D011247:Pregnancy