ABSTRACT : Epidural space catheterisation is a widely practised mode of alleviating post operative pain and morbidity. Though considered safe, it can occasionally lead to infections and fatal complications. This study was undertaken to determine the prevalence and risk factors of microbial colonization of lumbar epidural catheter tips and infectious complications in post operative patients.

METHODS : In this prospective, non randomised, observational study, conducted in KMC Hospitals, Mangalore, we selected 500 patients irrespective of age, gender and ASA status scheduled for abdominal, pelvic and lower limb surgeries requiring epidural analgesia. Epidural catheters were inserted under strict aseptic precautions-level of insertion, number of skin pricks were noted .Post op analgesia was given as infusion or intermittent boluses and duration noted. While removing catheters, skin swab from insertion site and epidural catheter tip were collected in sterile bottles and sent for culture; signs of local infection were inspected and noted if present. The data was analysed statistically.

RESULTS : No cases of local or systemic infection were noted. The number of catheter tips which showed positive cultures were statistically insignificant (p>0.05). However, the organisms isolated from the tip and skin swab were identical and the most common organism was Staph.epidermidis- a skin commensal.

CONCLUSIONS : Our results demonstrate that the presence of positive tip cultures may not always signify infection. Adequate skin antiseptic preparation prior to insertion and regular post operative follow up are adequate to prevent infections and routine cultures may not be required.