Effects of Cleaning an Epidural Catheter Hub with Alcohol and Determination of Neurotoxicity on Rat Astrocyte Cells

Minton, Brandon
Yamber, Courtney
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Patient safety must always be the first concern for anesthesia providers and aligning with evidence-based research provides best practice standards. The standard for cleansing the epidural catheter hub is rudimentary and poorly established as shown by the variations in current practice. Difference in opinions exists between cleansing the epidural catheter hubs with alcohol for bolusing administrations and the risk of causing adhesive arachnoiditis and/or neurolysis/apoptosis in the epidural space. A literature review revealed research concerning skin cleansing prior to placement of neuraxial anesthesia; however, the evidence was absent regarding best practice for epidural catheter hub access. Commentary and guidelines were made based on poor outcomes of two case studies, but no research has focused on epidural catheter hub aseptic techniques and risks to date. The intention of this scholarly project was to conduct an experimental study design with five epidural catheters and pumps infusing onto commercially available rat astrocyte cells after cleansing the epidural hubs with 70% isopropyl alcohol to test the potential presence of alcohol introduced into the epidural space and the risk of adhesive arachnoiditis and neurolysis/apoptosis. Each epidural pump would run an infusion into a sample size of five commercially available rat astrocyte cells. At completion of infusion, the commercially available rat astrocyte cells would be analyzed to determine the presence of alcohol in the cells. Data would be gathered by student co-investigators and sent for analysis using a statistical analysis software package. These results are intended to provide evidence-based recommendations for cleansing epidural catheter hubs with alcohol in anesthesia practice. Due to the nature of this scholarly project and unforeseen limitations the completion of proposed methods was not possible.