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British Journal of Anaesthesia, 2002, Vol. 89, No. 6 922-924
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Short Communications

Bacterial contamination of epidural needles after multiple skin passes

C. Orlikowski*,1, P. M. Majedi1 and A. D. Keil2

1 Department of Anaesthesia and 2 Department of Microbiology, King Edward Memorial Hospital for Women, Bagot Road, Subiaco, WA 6008, Australia Department of Anaesthetics, Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tasmania 7001, Australia

Background. Infection and epidural abscess are important complications of epidural analgesia. Difficult insertion may be associated with an increased risk of bacterial contamination of the epidural needle or catheter.

Methods. Bacterial contamination of epidural needles and trocars after difficult epidural insertion, defined as two or more skin passes, was assessed in 38 obstetric and ten gynaecological patients.

Results. There was no bacterial growth on any of the 48 epidural needles or trocars despite the mean (range) insertion time being 20 (10–30) min and the number of insertion attempts being 3 (2–4).

Conclusions. Difficult epidural insertion is not associated with an increased risk of needle contamination and is therefore an unlikely source of epidural infection.

Br J Anaesth 2002; 89: 922–4


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