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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gown group | Other | Anesthesiologists wearing sterile gown for epidural insertion |
|
| No Gown group | Other | Anesthesiologists not wearing gown for epidural insertion |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| wearing of sterile gowns | Procedure | Anesthesiologists wearing sterile gown for epidural insertion |
|
| Measure | Description | 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 |
| Measure | Description | Time Frame |
|---|---|---|
| length of epidural catheterization and positive culture | one year and a half |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Naveed T Siddiqui, MD | Department of Anesthesia and Pain Management Mount Sinai Hospital, Toronto,Canada | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Anesthesia Mount Sinai Hospital | Toronto | Ontario | M5G 1X5 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25304478 | Derived | Siddiqui NT, Davies S, McGeer A, Carvalho JC, Friedman Z. The effect of gowning on labor epidural catheter colonization rate: a randomized controlled trial. Reg Anesth Pain Med. 2014 Nov-Dec;39(6):520-4. doi: 10.1097/AAP.0000000000000171. |
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| No gown | Procedure | Anesthesiologists not wearing sterile gown for epidural insertion |
|