[Infection control in continuous peripheral regional anesthesia. Clinical study on disinfection time and subcutaneous tunneling in interscalene plexus anesthesia].
In the present study the efficacy of subcutaneous tunneling and a 10 min disinfection time with a 70% alcoholic solution to reduce the infection rate in continuous interscalene plexus anesthesia were examined. In a prospective study 1,134 continuous interscalene plexus anesthesias were included. In group 1 (473 catheters) a cotton swab was soaked with the alcoholic solution and swabbed 3 times at the puncture site in the classical manner. In group 2 (661 catheters) disinfection was carried out by spray and swab application with a disinfection time of at least 10 min. In group 1, 19% of the catheters were tunneled subcutaneously, whereas in group 2 this occurred in 89%. In group 1 inflammation occurred in 25 cases (5.3%) and an infection in 32 cases (6.8%). In group 2 there were 37 cases of inflammation (5.5%) and 13 infections (2.0%). The difference between the groups in the infection rate is statistically significant (p<0.002). The practicability of the 10 min disinfection time in the clinical routine was excellent. A 10 min disinfection time with a 70% alcoholic solution combined with subcutaneous tunneling led to a significantly lower infection rate in continuous peripheral regional anesthesia in the neck of the patient.
Neuburger
M
M
Abteilung für Anästhesie und Intensivtherapie, Ortenau-Klinikum Achern, Achern. MichaelNeuburger@aol.com
Reisig
F
F
Zimmermann
L
L
Büttner
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001917:Brachial Plexus; D002404:Catheterization; D004203:Disinfection / Q000379:methods*; D000431:Ethanol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007249:Inflammation / Q000139:chemically induced / Q000453:epidemiology; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
D000891:Anti-Infective Agents, Local; D000431:Ethanol