Skin disinfection practice before skin anaesthesia, prior to neuraxial blockade : a survey of government hospital practices in South Africa
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Medpharm Publications
Abstract
ENGLISH ABSTRACT: Infectious complications following neuraxial block, although being of low incidence, may lead to morbidity and
mortality. Two common methods utilised for skin disinfection before skin anaesthesia prior to a neuraxial block are the isopropanol
only method (isopropanol method) and the full aseptic technique (classic method). The objective of this study was to survey
government-employed South African anaesthesiologists’ preference regarding the disinfection practices before the administration
of local anaesthetic agents to the skin prior to the performance of a neuraxial block.
Methods: Ethics approval was obtained prior to commencing the study. An electronic, web-based questionnaire in the form of a
survey was distributed to various anaesthetic departments in various government teaching hospitals in South Africa. Descriptive
statistics were used on the raw data using the Fisher exact test to measure associations between the different categorical variables.
Results: A significant response rate of 60.3% was achieved. Regarding subarachnoid blocks, more than half of the participants
(52.0%) that participated in the survey utilise the isopropanol method whereas less than half of the participants utilise the
isopropanol method when performing an epidural block. Close to 75% of participants with zero to five years anaesthetic experience
prefer the isopropanol method whilst only 20.9% of anaesthetists with more than ten years’ experience prefer the isopropanol
method when performing a subarachnoid block (p < 0.01).
Conclusion: Both methods described in this study (classic and isopropanol methods) are practised commonly by the participants
in the survey and neither the classic nor the isopropanol method dominates. Local guidelines need to address the technique used
to disinfect the skin before the administration of the local anaesthetic agent to the skin prior to performing a neuraxial block.
Description
CITATION: Coetzee, D. F., Senekal, A. & Scheepers, P. A. 2019. Skin disinfection practice before skin anaesthesia, prior to neuraxial blockade : a survey of government hospital practices in South Africa. Southern African Journal of Anaesthesia and Analgesia, 25(5):24-29, doi: 10.36303/SAJAA.2019.25.5.A4.
The original publication is available at http://www.sajaa.co.za/index.php/sajaa
The original publication is available at http://www.sajaa.co.za/index.php/sajaa
Keywords
Anaesthesia, Local anesthetics, Central Neuraxial Blocks, Surgery, Aseptic and antiseptic
Citation
Coetzee, D. F., Senekal, A. & Scheepers, P. A. 2019. Skin disinfection practice before skin anaesthesia, prior to neuraxial blockade : a survey of government hospital practices in South Africa. Southern African Journal of Anaesthesia and Analgesia, 25(5):24-29, doi: 10.36303/SAJAA.2019.25.5.A4