
The American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) has developed comprehensive guidelines for preventing and managing infections in regional anesthesia and pain management procedures. These guidelines, commissioned in 2020, address a critical need in the field, as approximately 50% of surgical site infections are preventable when proper infection control practices are followed.
The guidelines were developed through a rigorous process involving over 80 research questions examined by working groups of experts. The recommendations cover multiple aspects of infection control, including:
– Preoperative patient risk assessment and management
– Sterile technique protocols
– Equipment use and maintenance
– Healthcare setting considerations (office, hospital, operating room)
– Surgical techniques
– Postoperative risk reduction
– Infection symptoms, diagnosis, and treatment
Key recommendations include proper timing of antibiotic administration, specific protocols for different types of procedures, and detailed hand hygiene requirements. The procedures are classified into different risk categories, from low-risk peripheral nerve blocks to high-risk surgical interventional procedures, each with specific infection control measures.
The guidelines have already shown promising results in practice. For instance, in spinal cord stimulation procedures, implementing these infection control measures led to a remarkable 10-fold reduction in infection rates.
The recommendations are designed to be practical and adaptable, acknowledging that each patient’s case is unique and requires individualized consideration. They serve as a blueprint for clinical decision-making rather than rigid rules, allowing healthcare providers to weigh risks and benefits for each scenario.
The guidelines emphasize the importance of ongoing updates as new evidence emerges. They integrate recommendations from multiple authoritative sources, including the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and other relevant organizations, making them comprehensive and globally applicable.
These guidelines represent a significant step forward in standardizing infection control practices in pain medicine and regional anesthesia, ultimately aiming to improve patient safety and outcomes through evidence-based practices.
Source: rapm.bmj.com/content/early/2025/01/14/rapm-2024-105651