Anesthesia Management: Gowning before labor epidural

Here is another blog based on the clinical practice of anesthesia.  Taking the time to put on a gown before inserting a labor epidural may do little to prevent infections in pregnant women while they are in labor.

A study presented by Dr Siddiqui and colleagues at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.  There were 240 women in labor requesting labor epidural showed that anesthesiologist who wore gowns were less likely to have bacteria present of their forearms.  But when they did not wear the garments, bacteria mostly did not reach the catheter tip anyway.  This finding suggests that the extra time and effort of sterile gowning may not be worth it for epidurals.  The author Naveed T. Siddiqui, MD, MSc, assistant professor in the Department of Anesthesia and Pain Management at the University of Toronto, Canada stated “the message is pretty clear from the data: Gowning will not make a difference in terms of bacterial growth.”  

Infections are relatively rare occurrences in epidurals affecting approximately 1 in 10,000 pts but those that do happen are a huge source of morbidity.  An infection can lead to an epidural abscess that can cause permanent paralysis or even death.