Infection as a complication of neuraxial blockade

Reynolds, F.

doi:10.1016/j.ijoa.2005.04.001

Cited by 44 publications

(30 citation statements)

References 74 publications

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“…Although deep tissue infections arise through a number of mechanisms, 9,14 local skin infections at the catheter entry site may progress to subcutaneous, epidural, paravertebral, paraspinal or meningeal infections. Nevertheless these deep tissue infections are rare and the reported incidence of epidural abscess in the obstetric population specifically is 0.2-48 in 100 000.…”

Section: Discussionmentioning

confidence: 99%

Obstetric epidural catheter-related infections at a major teaching hospital: a retrospective case series

Green

Paech

2010

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Obstetric epidural catheter-related infections at a major teaching hospital: a retrospective case series

Green

Paech

2010

International Journal of Obstetric Anesthesia

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“…Finally, use of bacterial filters for both bolus dosing and maintenance infusions may prevent seeding of the catheter and/or epidural space with pathogenic organisms arising from contaminated syringes or solutions. 16 In conclusion, a parturient developed an EA despite strict adherence to a standard protocol involving appropriate skin preparation, accepted aseptic technique (mask, cap, sterile gloves), and use of a bacterial filter. The placement of the epidural was notably atraumatic.…”

Section: Discussionmentioning

confidence: 98%

Case report: Epidural abscess in a parturient with pruritic urticarial papules and plaques of pregnancy (PUPPP)

Cummings

Dolak

2006

Can J Anesth/J Can Anesth

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Purpose: To describe the risk factors for epidural abscess (EA) formation following epidural analgesia in a parturient with pruritic urticarial papules and plaques of pregnancy (PUPPP). Clinical Features: A 33 yr-old gravida 2 nulliparous patient at 36 weeks gestation presented with severe pre-eclampsia, and PUPPP (treated with prednisone). Magnesium prophylaxis was started and labour was induced. An epidural catheter was placed at the L 3-4 level using standard aseptic technique. Bupivacaine was incrementally injected to achieve a T 10 sensory level, and analgesia was maintained using a continuous infusion of 0.0625% bupivacaine with fentanyl. Nine days post-delivery, the patient developed back pain radiating to her right leg, but she was otherwise asymptomatic. She was afebrile; with a slightly tender, nonerythematous, non-draining, 1 cm nodule at the epidural catheter site. Motor and sensory examinations were normal at that time. However, the patient returned 24 hr later and further investigations revealed: WBC 17,800·mm . The magnetic resonance imaging demonstrated an EA at the L 3-4 level causing minimal cord compression. The patient underwent an emergency decompressive laminectomy. Cultures revealed methicillin-sensitive Staphylococcus aureus. Her pain improved, and she was discharged on the third postoperative day with a six-week course of iv ceftriaxone. Conclusion: Causative organisms for EAs include coagulasenegative Staphylococci, S. aureus, and Gram-negative bacilli. Infection can occur either hematogenously or by direct contamination during catheter placement. Risk factors include immunocompromised states and PUPPP, as with the case of this patient. Objectif : Décrire les facteurs de risque d'abcès péridural (AP) à la suite d'une analgésie péridurale chez une parturiente qui présente des papules et des plaques prurigineuses urticariennes de la grossesse (PPPUG). Éléments cliniques : Une femme de 33 ans, nullipare, secondigeste, a consulté pour une sévère pré-éclampsie et des PPPUG (traitées avec de la prednisone) à 36 semaines de grossesse. L'administration préventive de magnésium a été amorcée et le travail induit. Un cathéter péridural a été placé à L3-4 selon la tech

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“…The latter is more common when the dural has been breached and the causative organism is often isolated from the upper airway of the operator, especially if aseptic technique has been poor. 11 Prevention Careful assessment before performing regional blockade is essential. Aseptic technique must be of a high standard.…”

Section: Anaesthetic Causesmentioning

confidence: 99%