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BJA Advance Access originally published online on October 30, 2006
British Journal of Anaesthesia 2007 98(1):131-135; doi:10.1093/bja/ael288
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Efficacy of spray disinfection with a 2-propanol and benzalkonium chloride containing solution before epidural catheter insertion—a prospective, randomized, clinical trial

G. Debreceni1,*, R. Meggyesi2 and G. Mestyán3

1 Department of Anaesthesiology and Intensive Care, University of Pécs Hungary
2 Anaesthesiology Residency Program, Ministry of Health Hungary
3 Department of Microbiology, University of Pécs, Medical Center Hungary

*Corresponding author: Department of Anaesthetics, Monklands Hospital, Lanarkshire NHS Trust, Monkscourt Avenue, Airdrie ML6 0JS, UK. E-mail: drdebrecenig{at}hotmail.com

Background. Skin disinfection before neuroaxial blockade procedures is usually obtained with sterile swabs impregnated in disinfectant. Spray disinfection is also an option which is frequently used in minor invasive procedures. The purpose of our study was to compare the efficacy of conventional swab disinfection with spray disinfection prior to epidural catheterization.

Methods. Seventy patients who requested epidural analgesia were randomly selected. The first group (n=35) received disinfection with swabs (SW) containing 2-propanol and benzalkonium chloride. The other 35 patients received spray (SP) disinfection with the same solution. Three microbiological cultures were obtained: one culture prior to skin disinfection, a second immediately after disinfection and a third from the tip of the epidural catheter upon removal.

Results. One patient in the SW group had a positive skin culture immediately after the disinfection with a very low number of colony forming units. The other skin culture specimens were all sterile in both groups. The colonization rate of catheters was not statistically different between the groups at removal.

Conclusion. In this study, spray disinfection was equally efficacious compared with the conventional skin disinfectant technique. Our results support the routine use of this simple and cheap alternative method of skin disinfection before epidural anaesthesia.


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E-letters:

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Spray or Swab?
Thillaiampalam Kathirgamanathan
British Journal of Anaesthesia, 22 Jan 2007 [Full text]
Spray or swab before epidurals?
Gabor Debreceni
British Journal of Anaesthesia, 5 Feb 2007 [Full text]

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