Bacterial contamination of epidural needles after multiple skin passes.

BACKGROUND Infection and epidural abscess are important complications of epidural analgesia. Difficult insertion may be associated with an increased risk of bacterial contamination of the epidural needle or catheter. METHODS Bacterial contamination of epidural needles and trocars after difficult epidural insertion, defined as two or more skin passes, was assessed in 38 obstetric and ten gynaecological patients. RESULTS There was no bacterial growth on any of the 48 epidural needles or trocars despite the mean (range) insertion time being 20 (10-30) min and the number of insertion attempts being 3 (2-4). CONCLUSIONS Difficult epidural insertion is not associated with an increased risk of needle contamination and is therefore an unlikely source of epidural infection.