Pregnancy
Conditions
Keywords
Epidural analgesia, Epidural anesthesia labor, Aseptic technique, gown, no gown
Brief summary
There is an increasing trend in the incidence of infection related to epidural anesthesia. This could be related to methods of aseptic technique as adopted by the anesthesiologist during the performance of the procedure. The purpose of this study is to compare two methods of aseptic technique for labor epidural insertion; a conventional method without wearing a sterile gown (free from living germs or microorganisms) versus strict aseptic method with wearing of sterile gowns. It is our belief that there will be an increased contamination of epidural equipment and colonization of epidural catheter, secondary to bacterial fallout from the operators' bare hands in the group not wearing the sterile gowns.
Detailed description
At the present time there is no accepted standard for aseptic technique during insertion of an epidural catheter on the labor floor and what is considered to be essential is controversial. Recognizing this, the American Society of Regional Anesthesia (ASRA), the leading authority on regional anesthesia, established a task force to examine and establish guidelines for aseptic practice. Their findings highlighted the lack of good quality studies to support specific recommendations. This is especially true in regards to the use of sterile gowns during the performance of the procedure.
Interventions
Anesthesiologists wearing sterile gown for epidural insertion
Anesthesiologists not wearing sterile gown for epidural insertion
Sponsors
Study design
Eligibility
Inclusion criteria
* All pregnant women requesting epidural analgesia
Exclusion criteria
* Patients who have fever requiring antibiotics * Patients who have received antibiotics in or within the previous 48 hours of labor * Immuno-compromised patients.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Growth of microbial organisms on operators forearm, agar plate (working area) and proximal and distal tip of the epidural catheter. | one and one half year |
Secondary
| Measure | Time frame |
|---|---|
| length of epidural catheterization and positive culture | one year and a half |
Countries
Canada