Bacterial contamination of epidural needles after multiple skin passes

Background. Infection and epidural abscess are important complicationsof epidural analgesia. Difficult insertion may be associatedwith an increased risk of bacterial contamination of the epiduralneedle or catheter. Methods. Bacterial contamination of epidural needles and trocarsafter difficult epidural insertion, defined as two or more skinpasses, was assessed in 38 obstetric and ten gynaecologicalpatients. Results. There was no bacterial growth on any of the 48 epiduralneedles or trocars despite the mean (range) insertion time being20 (10–30) min and the number of insertion attempts being3 (2–4). Conclusions. Difficult epidural insertion is not associatedwith an increased risk of needle contamination and is thereforean unlikely source of epidural infection. Br J Anaesth 2002; 89: 922–4