International Journal of Obstetric Anesthesia
Volume 19, Issue 1 , Pages 38-43 , January 2010

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

  • L.K. Green

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr Lloyd Green, Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, 374 Bagot Rd, Subiaco, Western Australia 6008, Australia.
  • ,
  • M.J. Paech

,Accepted 6 June 2009.

References 

  1. Hlavin M, Kaminski H, Ross J, Ganz E. Spinal epidural abscess: A ten-year perspective. Neurosurg. 1990;27:177–184
  2. Loo C, Dahlgren G, Irestedt L. Neurological complications in obstetric regional anaesthesia. Int J Obstet Anesth. 2000;9:99–124
  3. Schroeder T, Krueger W, Neeser E, Hahn U, Unertl K. Spinal epidural abscess - a rare complication after epidural analgesia for labour and delivery. Br J Anaesth. 2004;92:896–898
  4. Ruppen W, Derry S, McQuay H, Moore A. Incidence of epidural hematoma, infection and neurological injury in obstetric patients with epidural analgesia/anesthesia. Anesthesiology. 2006;105:394–399
  5. Kindler C, Seeberger M, Siegermund M, Schneider M. Extradural abscess complicating lumbar extradural anaesthesia and analgesia in an obstetric patient. Acta Anaesthesiol Scand. 1996;40:858–861
  6. Moen V, Dahlgren N, Irestedt L. Severe neurological complications after central neuraxial blockades in Sweden 1990–1999. Anesthesiology. 2004;101:950–959
  7. Katircioglu K, Hasegeli L, Ibrahimhakkioglu HF, Ulusoy B, Damar H. A retrospective review of 34,109 epidural anesthetics for obstetric and gynecological procedures at a single private hospital in Turkey. Anesth Analg. 2008;107:1742–1745
  8. Paech MJ, Godkin R, Webster S. Complications of obstetric epidural analgesia and anaesthesia: a prospective analysis of 10995 cases. Int J Obstet Anesth. 1998;7:5–11
  9. Grewal S, Hocking G, Wildsmith JAW. Epidural abscesses. Br J Anaesth. 2006;96:292–302
  10. Breivik H. Infectious complications of epidural anaesthesia and analgesia. Curr Opin Anaesthesiol. 1999;12:573–577
  11. Burstal R, Wegener F, Hayes C, Lantry G. Epidural analgesia: a prospective audit of 1062 patients. Anaesth Intensive Care. 1998;26:165–172
  12. Holt HM, Andersen SS, Andersen O, Gahrn-Hansen B, Siboni K. Infections following epidural catheterization. J Hosp Infect. 1995;30:253–260
  13. Cameron CM, Scott DA, McDonald WM, Davies MJ. A review of neuraxial epidural morbidity. Experience of more than 8,000 cases at a single teaching hospital. Anesthesiology. 2007;106:997–1002
  14. Reynolds F. Infection as a complication of neuraxial blockade. Int J Obstet Anesth. 2005;14:183–188
  15. Wang LP, Hauerberg J, Schmidt JF. Incidence of spinal epidural abscess after epidural analgesia. Anesthesiology. 1999;91:1928–1936
  16. Christie IW, McCabe S. Major complications of epidural analgesia after surgery: results of a six-year survey. Anaesthesia. 2007;62:335–341
  17. Phillips JMG, Stedeford JC, Hartsilver E, Roberts C. Epidural abscess complicating insertion of epidural catheters. Br J Anaesth. 2002;89:778–782
  18. Sakuragi T, Yasunaka K, Hirata K, Hori K, Dan K. The source of epidural infection following epidural analgesia identified by pulsed-field gel electrophoresis. Anesthesiology. 1998;89:1254–1256
  19. Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM. Bacterial spinal epidural abscess. Review of 43 cases and literature survey. Medicine (Baltimore). 1992;71:369–385
  20. Reihsaus E, Waldbaur H, Seeling W. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev. 2000;23:175–204
  21. Friedman Z, Siddiqui N, Katznelson R, Devito I, Davies S. Experience is not enough. Repeated breaches in epidural anesthesia aseptic technique by novice operators despite improved skill. Anesthesiology. 2008;108:914–920
  22. Sprigge JS, Harper SJ. Accidental dural puncture and post dural puncture headache in obstetric anaesthesia: presentation and management: A 23-year survey in a district general hospital. Anaesthesia. 2008;63:36–43
  23. Reynolds F. Neurological infections after neuraxial anesthesia. Anesthesio Clin. 2008;26:23–52
  24. Orlikowski C, Majedi P, Keil A. Bacterial contamination of epidural needles after multiple skin passes. Br J Anaesth. 2002;89:922–924
  25. Sarubbi FA, Vasquez JE. Spinal epidural abscess associated with the use of temporary epidural catheters: Report of two cases and review. Clin Infect Dis. 1997;25:1155–1158
  26. Langevin PB, Gravenstein N, Langevin SO, Gulig PA. Epidural catheter reconnection. Safe and unsafe practice. Anesthesiology. 1996;85:883–888
  27. Kuczkowski KM. Accidental disconnection of the epidural catheter: to reconnect or replace?. Acta Anaesthesiol Scand. 2005;49:259
  28. Birnbach D, Hernandez M, van Zundert A. Neurological complications of neuraxial analgesia for labor. Curr Opin Anaesthesiol. 2005;8:513–517
  29. Raj V, Foy J. Paraspinal abscess associated with epidural in labour. Anaesth Intensive Care. 1998;26:424–426
  30. Huang YY, Zuo Z, Yuan HB, Tsou MY, Chen MT, Tsai SK. A paraspinal abscess following spinal anaesthesia for caesarean section and patient-controlled epidural analgesia for postoperative pain. Int J Obstet Anesth. 2005;14:252–255
  31. Hill JS, Hughes EW, Robertson PA. A Staphylococcus aureus paraspinal abscess associated with epidural analgesia in labour. Anaesthesia. 2001;56:873–878
  32. Lee BB, Ngan Kee WD, Griffith JF. Vertebral osteomyelitis and psoas abscess occurring after obstetric epidural anesthesia. Reg Anesth Pain Med. 2002;27:220–224
  33. Hernandez-Palazon J, Puertas-Garcia JP, Martinez-Lage JF, Tortosa JA. Lumbar spondylodiscitis caused by Propionibacterium acnes after epidural obstetric analgesia. Anesth Analg. 2003;96:1486–1488
  34. Mulvey JM. Postpartum septic sacroiliitis coincident with labour epidural analgesia. Anaesth Intensive Care. 2008;36:875–878
  35. Del Curling OJ, Gower D, McWhorter J. Changing concepts in spinal epidural abscess: a report of 29 cases. Neurosurg. 1990;27:185–192
  36. Dysart RH, Balakrishnan V. Conservative management of extradural abscess complicating spinal-extradural anaesthesia for caesarean section. Br J Anaesth. 1997;78:591–593
  37. Cook T, Counsell D, Wildsmith JA on behalf of The Royal College of Anaesthetists Third National Audit Project.. Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists. Br J Anaesth. 2009;102:179–190
  38. http://www.asahq.org/Newsletters/2005/04–05/dangelo04_05.html Accessed February 2009.

PII: S0959-289X(09)00127-7

doi: 10.1016/j.ijoa.2009.06.001

International Journal of Obstetric Anesthesia
Volume 19, Issue 1 , Pages 38-43 , January 2010