Infusate Contamination in Regional Anesthesia: What Every Anesthesiologist Should Know
Bibliographic record
Abstract
Infection can be a devastating complication of regional anesthesia. Contaminated infusate as a cause of infection in neuraxial anesthesia or peripheral nerve blockade has rarely been reported in the literature. However, it may be an important source of morbidity, especially as increasing numbers of patients are being discharged with perineural catheters and portable pumps of local anesthetic, which may infuse for several days at home. Two important issues related to infusate contamination in regional anesthesia are that of "hang-time" and sterile compounding practices. Hang-time can be defined as the maximum length of time during which an admixture preparation (infusate) can be safely administered without risk of microbiological or chemical instability. In the United States, there are currently no national guidelines on the hang-times of regional anesthesia infusates. On the other hand, guidelines for the sterile compounding of infusions used in regional anesthesia are now established by United States Pharmacopeia and The National Formulary Chapter 797, entitled "Pharmaceutical Compounding, Sterile Preparations." These guidelines have significant implications for the anesthesiologist. In this review, we examined the available literature regarding contaminated infusate as a cause of infection in regional anesthesia, to discuss strategies for the prevention of such contamination including the appropriate hang-time for infusates, and to discuss the implications of United States Pharmacopeia and The National Formulary Chapter 797 for anesthesiologists.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.008 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".