Infection in Association with Local and Regional Anesthesia

  • Terese T. Horlocker
  • Denise J. Wedel
  • Adam D. Niesen

Key Points

  • Infections associated with regional anesthesia may be more prevalent than previously thought and are associated with various risk factors. In general, central neuraxial block should not be performed in patients with untreated systemic infection except in the most extraordinary circumstances.

  • Strict adherence to aseptic technique, including masks and gloves, skin disinfection, and maintaining sterility of equipment, is critical to avoid infection and colonization of potentially harmful bacteria.

  • Epidural abscess is most likely to occur in immunocompromised patients with prolonged durations of epidural catheterization, with the most common causative organism being S. aureus. In contrast, meningitis following neuraxial blockade occurs more frequently in healthy individuals who have undergone uneventful spinal anesthesia.

  • In general, neuraxial blocks in patients with preexisting viral disease (herpes, HIV) or who are immunocompromised are safe; however, the usual precautions and safety measures are still recommended.

  • The patient care team must be vigilant of any signs or symptoms of infection so that the source can be identified and treatment be initiated as early as possible.


Regional anesthesia Spinal anesthesia Epidural anesthesia Peripheral block Complications Infection Meningitis Epidural abscess Patient safety Guidelines 


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Terese T. Horlocker
    • 1
  • Denise J. Wedel
    • 1
  • Adam D. Niesen
    • 1
  1. 1.Department of AnesthesiologyMayo Clinic College of MedicineRochesterUSA

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