Infection control guidelines focus on regional anesthesia, pain management

Editor's Note

New infection control recommendations from the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) are purportedly the first comprehensive guidelines tailored specifically for regional anesthesia and interventional pain management procedures, such as cortisone injections and drug-delivery implants.  

As detailed in the organization’s January 21 announcement, the guidelines were developed over three years by 23 experts in anesthesia, pain medicine, and infectious diseases. They analyzed over 80 research questions and classified procedures into categories such as musculoskeletal blocks, neuraxial interventions, and surgical-type pain procedures. The guidance preoperative, intraoperative, and postoperative infection prevention, including patient risk assessment, sterile techniques, and environmental controls. Key recommendations include:

• Administering intravenous antibiotics before invasive procedures and assess patient-specific risks like diabetes or advanced age.
• Using sterile probe covers, disinfection techniques for syringes and injection ports, and bio-occlusive dressings after surgical procedures.
• Emphasizing hand hygiene and appropriate equipment maintenance.

According to the announcement, surgical site infections (SSIs) represent the second most common type of healthcare-associated infection (HAI) in the U.S., accounting for 20% of all HAIs and costing $3.3 billion annually. While infection rates for interventional pain procedures are generally low, untreated infections can lead to severe outcomes, including paralysis and death. Non-compliance with evidence-based infection control practices remains a challenge. An international survey revealed compliance rates of less than 80% for most infection prevention measures related to spinal cord stimulator implants. These guidelines aim to reduce SSIs, improve patient outcomes, and lower healthcare costs.