Sepsis et analgésie locorégionale

Regional analgesia with epidural or continuous peripheral nerve block catheters produce effective pain relief and continue to be increasingly used after surgery. The frequency of infection associated with those catheters remains poorly defined, but recent studies show that between 1 and 30% of catheters may become colonized, with 1% resulting in localized infection. An exogenous source of contamination is frequently suspected. The most frequently detected microorganism on the skin surface and in colonized catheter is Staphylococcus epidermidis. Risk factors are: patients (diabetes, intensive care unit or trauma patients), catheter site insertion, prophylactic antibiotic use, local anaesthetic solution contamination, and catheter duration. Several recommendations based on recent published studies have been proposed to decrease infectious complication.