Analisis Komplikasi Infeksi Terkait Tindakan Blok Epidural pada Pasien Pasca Operasi Di RSUD Dr. Zainoel Abidin Banda Aceh
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Keywords

Epidural Catheter Infection
Epidural Catheter Culture
Epidural Block

How to Cite

Zafrullah Khany Jasa, Yusmalinda, & Hafizh Arief. (2023). Analisis Komplikasi Infeksi Terkait Tindakan Blok Epidural pada Pasien Pasca Operasi Di RSUD Dr. Zainoel Abidin Banda Aceh. Journal of Medical Science, 3(2), 112–120. https://doi.org/10.55572/jms.v3i2.88

Abstract

Neuraxial block-associated infection is a rare complication, this could be due to better aseptic technique and possibility of unreported events. There are four mechanisms by which microorganisms enter the body during insertion of an epidural catheter, include inoculation of microorganisms on the skin surface, pathways along the insertion of epidural catheter, contamination of local anesthetic drugs, and hematogenous spread. The aim of the study is to find out incidence of infectious complications and risk factors for infection in patients who had an epidural catheter inserted in dr. Zainoel Abidin hospital Banda Aceh. A cross-sectional study was conducted over 3 months period with 45 total sampling patients who received epidural blocks. Analysis was done to know relationship beetwen age, number of attempts at insertion of epidural needles, duration of catheter in situ, comorbid DM, malignancy, duration of postoperative bed rest, and blood leukocyte count, signs of inflammation, neurological deficits, and bacterial culture of the epidural catheter. No infection was found, however there were 14 positive epidural catheter culture obtained Gram-negative rods. Nine of the 14 positive culture samples were patients with malignancy. All patients with positive culture samples had bed rest ≥2 days (p=0.004). No asociation between dependent and independent variables in this study (p>0.05). Positive culture results cannot be defined as an infection, however colonization at epidural catheter tip is an early sign of an imminent infectious process.

https://doi.org/10.55572/jms.v3i2.88
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References

Abram, S. E. (2007). Complications Associated with Epidural, Facet Joint, and Sacroiliac Joint Injections. Dalam Neal, J. M & Rathmell, J. P (Ed.): Complications in Regional Anesthesia & Pain Medicine W.B. Saunders. https://doi.org/10.1016/B978-1-4160-2392-0.50029-7.

Amadoru, S., Lim, K., Tacey, M., & Aboltins, C. (2017). Spinal infections in older people: an analysis of demographics, presenting features, microbiology and outcomes. Inter Med J, 47(2), 182–188. https://doi.org/10.1111/imj.13300.

American Society of Anesthesiologists. (2017). Practice Advisory for the Prevention, Diagnosis, and Management of Infectious Complications Associated with Neuraxial Techniques: An Updated Report by the American Society of Anesthesiologists Task Force on Infectious Complications Associated with Neuraxial Techniques and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology, 126(4), 585–601. https://doi.org/10.1097/ALN.0000000000001521.

Bomberg, H., Bayer, I., Wagenpfeil, S., Kessler, P., Wulf, H., Standl, T., Gottschalk, A., Döffert, J., Hering, W., Birnbaum, J., Spies, C., Kutter, B., Winckelmann, J., Liebl-Biereige, S., Meissner, W., Vicent, O., Koch, T., Sessler, D.I., Volk, T., & Raddatz, A. (2018). Prolonged Catheter Use and Infection in Regional Anesthesia: A Retrospective Registry Analysis. Anesthesiology, 128(4), 764–773. https://doi.org/10.1097/ALN.0000000000002105.

Bomberg, H., Kubulus, C., List, F., Albert, N., Schmitt, K., Gräber, S., dkk. (2015). Diabetes: A Risk Factor for Catheter-Associated Infections. Reg Anesth Pain Med, 40(1), 16−21. https://doi.org/10.1097/AAP.0000000000000196.

Borgoni, S., Kudryashova, K. S., Burka, K., & de Magalhães, J. P. (2021). Targeting immune dysfunction in aging. Ageing Res Rev, 70, 101410. https://doi.org/10.1016/j.arr.2021.101410.

Brull, R., MacFarlane, A. J., & Chan, V. W. (2020). Spinal, Epidural, and Caudal Anesthesia. Dalam M. A. Gropper (Ed.). Miller’s Anesthesia 9th ed. Elsevier.

Exner, M., Bhattacharya, S., Christiansen, B., Gebel, J., Goroncy-Bermes, P., Hartemann, P., dkk. (2017). Antibiotic resistance: What is so special about multidrug-resistant Gram-negative bacteria? GMS Hyg Infec Control, 12, Doc05–Doc05. https://doi.org/10.3205/dgkh000290.

Fleming, L. T., & Leung, P. H. (2020). Effects of friction and pressure on skin in relation to pressure ulcer formation. Dalam A. Gefen (Ed.): Innovations and Emerging Technologies in Wound Care. Academic Press. https://doi.org/10.1016/B978-0-12-815028-3.00015-8.

Harianto, W. Y., & Mahmud, U. W. (2020). Perbandingan Chlorhexidine 0,5% dan Povidone Iodine 10% Dalam Mencegah Kolonisasi Bakteri Pada Kateter Epidural. Jurnal Komplikasi Anestesi, 7(3).

Hidayat, I. N., & Surahman, E. (2015). Gambaran Jenis Bakteri pada Ujung Kateter Epidural di Rumah Sakit Dr. Hasan Sadikin Bandung. JAP, 3(1), 33–37.

Kaafarani, H. M. A., & Itani, K. M. F. (2020). Inflammation, Infection, & Antimicrobial Therapy in Surgery. Dalam G. M. Doherty (Ed.): Current Diagnosis & Treatment: Surgery, 15e. McGraw Hill LLC.

Long, B., Carlson, J., Montrief, T., & Koyfman, A. (2022). High risk and low prevalence diseases: Spinal epidural abscess. Am J Emerg Med, 53, 168–172. https://doi.org/10.1016/j.ajem.2022.01.008.

Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. J Am Acad Dermatol, 81(4), 881–890. https://doi.org/10.1016/j.jaad.2018.12.069.

Pérez Barragán, E., Sandino Pérez, J., Corbella, L., Orellana, M. A., & Fernández-Ruiz, M. (2018). Achromobacter xylosoxidans bacteremia: clinical and microbiological features in a 10-year case series. Revista Espanola de Quimioterapia: Publicacion Oficial de La Sociedad Espanola de Quimioterapia, 31(3), 268–273. https://pubmed.ncbi.nlm.nih.gov/29806765.

Ruppen, W., Derry, S., McQuay, H. J., & Moore, R. A. (2007). Infection rates associated with epidural indwelling catheters for seven days or longer: systematic review and meta-analysis. BMC Palliative Care, 6(1), 3. https://doi.org/10.1186/1472-684X-6-3.

Schulz-Stübner, S., Pottinger, J. M., Coffin, S. A., & Herwaldt, L. A. (2017). Infection Control in Regional Anesthesia. Dalam Hadzic, A. (Ed.): Hadzic’s Textbook of Regional Anesthesia and Acute Pain Management, 2e. McGraw-Hill Education.

Sethna, N. F., Clendenin, D., Athiraman, U., Solodiuk, J., Rodriguez, D. P., Zurakowski, D., & Warner, D. S. (2010). Incidence of Epidural Catheter-associated Infections after Continuous Epidural Analgesia in Children. Anesthesiology, 113(1), 224–232. https://doi.org/10.1097/ALN.0b013e3181de6cc5.

Sharfman, Z. T., Gelfand, Y., Shah, P., Holtzman, A. J., Mendelis, J. R., Kinon, M. D., dkk. (2020). Spinal Epidural Abscess: A Review of Presentation, Management, and Medicolegal Implications. Asian Spine J, 14(5), 742–759. https://doi.org/10.31616/asj.2019.0369.

Svensson-Raskh, A., Schandl, A. R., Ståhle, A., Nygren-Bonnier, M., & Fagevik Olsén, M. (2021). Mobilization Started Within 2 Hours After Abdominal Surgery Improves Peripheral and Arterial Oxygenation: A Single-Center Randomized Controlled Trial. Phys Ther, 101(5), pzab094. https://doi.org/10.1093/ptj/pzab094.

Taylor, A., & Grant, C. R. K. (2022). Complications of regional anaesthesia. Anaest Int Care Med, 23(3), 146–150. https://doi.org/10.1016/j.mpaic.2021.11.007.

Toledano, R. D., & van de Velde, M. (2017). Epidural Anesthesia and Analgesia. Dalam A. Hadzic (Ed.), Hadzic’s Textbook of Regional Anesthesia and Acute Pain Management, 2e. McGraw-Hill Education.

Van Samkar, G., Balraadjsing, P. P. S., Hermanns, H., Hoogendijk, I. V, Hollmann, M. W., Zaat, S. A. J., dkk. (2020). Microbiological and scanning electron microscopic evaluation of epidural catheters. Regional Anesthesia & Pain Medicine, 45(5), 381. https://doi.org/10.1136/rapm-2019-101180.

Wainaina, J. N. (2021). Prevention of Surgical Site Infections. Dalam S. L. Cohn (Ed.), Decision Making in Perioperative Medicine: Clinical Pearls. McGraw Hill.

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Copyright (c) 2023 Zafrullah Khany Jasa, Yusmalinda, Hafizh Arief

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