title: Perineural catheter infection: a systematic review of the literature.
abstract: Perineural catheter infection is a rare but potentially dramatic complication of continuous peripheral nerve block. Different risk factors have been identified and the incidence of infection is increased in trauma victims, intensive care unit patients, immunodeficient individuals, and diabetic patients. Also, postoperative hyperglycemia, the absence of antibiotic prophylaxis, and catheter lasting more than 48 hours seem to be associated with a greater risk of infection. Skin disinfection and a strict aseptic technique during catheter placement are fundamental. The use of micropore filters, antiseptic dressings, catheter tunneling, and aseptic preparation of the infused drug has all been hypothesized to reduce infection rate, but the existing evidence is conflicting. Infection is a rare complication of continuous peripheral nerve blocks. Severe and even fatal cases have been reported, even if morbidity is generally very low. The identification of high risk patients and adoption of preventive measures might reduce the incidence of this complication.
authors.affiliation: 2nd Department of Anesthesia, Intensive Care and Pain Medicine, Parma University Hospital, 43126, Parma, Italy. Electronic address: dnicolotti@parmanesthesia.com.
authors.forename: Davide
authors.initials: D
authors.lastname: Nicolotti
authors.affiliation: 2nd Department of Anesthesia, Intensive Care and Pain Medicine, Parma University Hospital, 43126, Parma, Italy; Department of Anesthesia and Intensive Care, S. Maria Nuova Hospital, 42123, Reggio Emilia, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Iotti
authors.affiliation: 2nd Department of Anesthesia, Intensive Care and Pain Medicine, Parma University Hospital, 43126, Parma, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Fanelli
authors.affiliation: 2nd Department of Anesthesia, Intensive Care and Pain Medicine, Parma University Hospital, 43126, Parma, Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Compagnone
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D057785:Catheters / Q000009:adverse effects*; D004340:Drug Contamination; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D015994:Incidence; D009407:Nerve Block / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local
keywords: Catheter-related infection; Continuous nerve block; Perineural catheter; Postoperative hyperglycemia; Postoperative infection