[Incidence of infection from catheter procedures for regional anesthesia: first results from the network of DGAI and BDA].
BACKGROUND
To analyze safety issues of regional anaesthesia and analgesia in Germany only a few single center studies are available. Therefore, the German Society for Anaesthesiology and Intensive Care Medicine (Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin, DGAI) and the Professional Association of German Anaesthetists (Berufsverband Deutscher Anästhesisten, BDA) initiated a network for safety in regional anaesthesia. From this the first results on infectious complications will be reported.


METHODS
In a Delphi process the documentation of the setup and maintenance of regional anaesthesia and analgesia was agreed with the participants in a working group from the DGAI. After approval by the officially authorized representative for patient data privacy protection a registry was programmed to collect anonymous data. Up to October 2008 data from 6 centers could be analyzed.


RESULTS
After testing for plausibility 8,781 regional anaesthesia procedures (22,112 catheter days) could be analyzed. The 5,057 neuraxial and 3,724 peripheral catheter-based procedures were in place for a median of 2.48 days (range 1.0-3.0 days) and 4 severe, 15 moderate and 128 mild infections were recorded. Diabetics were not found to show a statistically significant increase in risk (2.6% compared to 1.9% for non-diabetics: n.s.). Neuraxial procedures seem to have a higher rate of infections than peripheral procedures (2.7% vs. 1.3%, p<0.0001). Multiple punctures of the skin also seem to be associated with a higher infection rate than single skin punctures (4.1% vs. 1.6%, p<0.0001).


CONCLUSIONS
Infectious complications of catheter-based regional anaesthesia are common. Strict hygienic standards must therefore be complied with. More data are necessary to calculate risk factors. The registry provided can also be used as a benchmark to reduce these rates further.
Volk
T
T
Kliniken für Anästhesiologie und operative Intensivmedizin, Charité - Universitätsmedizin Berlin, Campus Charité Mitte und Campus-Virchow-Klinikum, Berlin, Deutschland. thomas.volk@uniklinikum-saarland.de
Engelhardt
L
L
Spies
C
C
Steinfeldt
T
T
Gruenewald
D
D
Kutter
B
B
Heller
A
A
Werner
C
C
Heid
F
F
Bürkle
H
H
Gastmeier
P
P
Wernecke
K-D
KD
Koch
T
T
Vicent
O
O
Geiger
P
P
Wulf
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000009:adverse effects; D000765:Anesthesia, Conduction / Q000009:adverse effects*; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D003697:Delphi Technique; D048909:Diabetes Complications / Q000453:epidemiology; D004282:Documentation; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006920:Hygiene; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects; D012042:Registries; D012306:Risk; D012449:Safety; D055815:Young Adult