Infection control in continuous peripheral regional anesthesia

In the present study the efficacy of subcutaneous tunneling and a 10 min disinfection time with a 70% alcoholic solution to reduce the infection rate in continuous interscalene plexus anesthesia were examined. In a prospective study 1,134 continuous interscalene plexus anesthesias were included. In group 1 (473 catheters) a cotton swab was soaked with the alcoholic solution and swabbed 3 times at the puncture site in the classical manner. In group 2 (661 catheters) disinfection was carried out by spray and swab application with a disinfection time of at least 10 min. In group 1, 19% of the catheters were tunneled subcutaneously, whereas in group 2 this occurred in 89%. In group 1 inflammation occurred in 25 cases (5.3%) and an infection in 32 cases (6.8%). In group 2 there were 37 cases of inflammation (5.5%) and 13 infections (2.0%). The difference between the groups in the infection rate is statistically significant (p < 0.002). The practicability of the 10 min disinfection time in the clinical routine was excellent. A 10 min disinfection time with a 70% alcoholic solution combined with subcutaneous tunneling led to a significantly lower infection rate in continuous peripheral regional anesthesia in the neck of the patient.