Reynolds Felicity
Department of Anaesthetics, St Thomas's Hospital, London, UK.
Anesthesiol Clin. 2008 Mar;26(1):23-52, v. doi: 10.1016/j.anclin.2007.11.006.
Infection is the commonest cause of serious neurologic sequelae of neuraxial anesthesia. The incidence depends on operator skill and patient population. Meningitis, a complication of dural puncture, is usually caused by viridans streptococci. The risk factors are dural puncture during labor, no mask and poor aseptic technique, vaginal infection and bacteremia. Epidural abscess is a complication of epidural catheterization, route of entry the catheter track and the organism usually the staphylococcus. Principal risk factors are prolonged catheterization, poor aseptic technique and traumatic insertion. Prevention includes wearing a mask, using a full sterile technique, avoiding prolonged catheterization and prescribing antibiotics in a high-risk situation.
感染是椎管内麻醉导致严重神经后遗症最常见的原因。其发生率取决于操作者的技术和患者群体。脑膜炎是硬膜穿刺的一种并发症，通常由草绿色链球菌引起。危险因素包括分娩时硬膜穿刺、未戴口罩及无菌技术不佳、阴道感染和菌血症。硬膜外脓肿是硬膜外导管置入的并发症，感染途径为导管通道，病原体通常为葡萄球菌。主要危险因素为导管留置时间过长、无菌技术不佳和穿刺时造成创伤。预防措施包括戴口罩、采用全面的无菌技术、避免导管留置时间过长以及在高危情况下使用抗生素。
