Comparison of two different antiseptics on contamination of epidural catheter tip

Objectives: The aim of the present study was to compare preventive effects of 10% povidone-iodine, and combination of 2-propanol and benzalkonium chloride skin antiseptics on contamination of epidural catheter tip. Methods: Included were 160 patients aged 18-65 years with American Society of Anesthesiologists (ASA) physical status classifications of I-II. Patients were randomized. Povidone-iodine was administered to group P (n = 80) prior to insertion of antibiotic prophylaxis catheter; 2-propanol and benzalkonium chloride was administered to group B. Swabs obtained before and after administration of antiseptics were sent for culture. Antiseptics were applied to skin prior to catheter removal, as well as 48 hours after insertion. In sterile conditions, 2-3 cm pieces of catheter tips were sent to laboratory. Preoperative and postoperative complete blood count, body temperature, and signs of postoperative localized skin infection were recorded. Results: Leukocyte, neutrophil, and lymphocyte counts were all within normal ranges in preoperative and postoperative. Swab cultures obtained following use of antiseptics were positive in 6 group P patients; coagulase-negative Staphylococcus was found in 5 patients, E. coli in 1, and were negative in group B. Difference between groups was statistically significant (p = 0.013). Epidural catheter tip cultures were negative. Conclusion: Combination of 2-propanol and benzalkonium chloride was determined to be more effective in reducing skin flora around epidural catheter insertion site.