Hygiene recommendations for regional anesthesia : Updated S1 guidelines of the working group regional anesthesia of the German Society for Anesthesiology

The updated S1 guideline from the German Society of Anesthesiology and Intensive Care Medicine provides recommendations on hygiene practices for central and peripheral regional anesthesia procedures, aiming to minimize the infection risk for patients. Central to the guideline is the consistent imple...

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Published in:Die Anaesthesiologie Vol. 74; no. 8; p. 504
Main Authors: Wiesmann, Thomas, Volk, Thomas, Heinen, Rebecca, Vicent, Oliver, Döffert, Jens, Schulz-Stübner, Sebastian, Geffers, Christine, Kubulus, Christine, Kessler, Paul, Göpfert, Matthias, Wendt, Constanze, Scheithauer, Simone, Wulf, Hinnerk, Steinfeldt, Thorsten, Schubert, Ann-Kristin
Format: Journal Article
Language:German
Published: Germany 01.08.2025
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ISSN:2731-6866, 2731-6866
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Abstract The updated S1 guideline from the German Society of Anesthesiology and Intensive Care Medicine provides recommendations on hygiene practices for central and peripheral regional anesthesia procedures, aiming to minimize the infection risk for patients. Central to the guideline is the consistent implementation of standardized hygiene measures, with particular emphasis on thorough hand hygiene by the practitioners before and after each procedure. Patient skin preparation should be performed directly with remanent, alcohol-based disinfectants, provided there is no visible contamination. Hair removal is recommended only when necessary, preferably using clippers. For all neuraxial procedures, the use of a face mask, head cover, and sterile gloves is mandatory. In the case of single-shot peripheral nerve blocks, the use of non-sterile disposable gloves may be acceptable depending on the circumstances. Only sterile single-use materials and freshly withdrawn medications from single-dose containers should be used to prevent crosscontamination. In ultrasound-guided procedures, the use of a sterile probe cover and thorough disinfection of the ultrasound transducer before and after use are obligatory. For indwelling regional anesthesia catheters, the insertion site must be inspected daily; dressing changes should be performed only when infection is suspected or when there is an evident clinical indication. Catheter tunneling and the use of chlorhexidine-containing dressings may contribute to reducing bacterial contamination. If signs of infection occur, targeted diagnostics and infection-specific treatment should be initiated, according to the severity of the clinical presentation. Additionally, the guideline recommends the introduction of hygiene bundles, standardized procedural kits, and regular staff training. These measures should be subject to continuous evaluation and optimization via structured monitoring and benchmarking. All recommendations must be adapted to local conditions and institution-specific hygiene protocols.
AbstractList The updated S1 guideline from the German Society of Anesthesiology and Intensive Care Medicine provides recommendations on hygiene practices for central and peripheral regional anesthesia procedures, aiming to minimize the infection risk for patients. Central to the guideline is the consistent implementation of standardized hygiene measures, with particular emphasis on thorough hand hygiene by the practitioners before and after each procedure. Patient skin preparation should be performed directly with remanent, alcohol-based disinfectants, provided there is no visible contamination. Hair removal is recommended only when necessary, preferably using clippers. For all neuraxial procedures, the use of a face mask, head cover, and sterile gloves is mandatory. In the case of single-shot peripheral nerve blocks, the use of non-sterile disposable gloves may be acceptable depending on the circumstances. Only sterile single-use materials and freshly withdrawn medications from single-dose containers should be used to prevent crosscontamination. In ultrasound-guided procedures, the use of a sterile probe cover and thorough disinfection of the ultrasound transducer before and after use are obligatory. For indwelling regional anesthesia catheters, the insertion site must be inspected daily; dressing changes should be performed only when infection is suspected or when there is an evident clinical indication. Catheter tunneling and the use of chlorhexidine-containing dressings may contribute to reducing bacterial contamination. If signs of infection occur, targeted diagnostics and infection-specific treatment should be initiated, according to the severity of the clinical presentation. Additionally, the guideline recommends the introduction of hygiene bundles, standardized procedural kits, and regular staff training. These measures should be subject to continuous evaluation and optimization via structured monitoring and benchmarking. All recommendations must be adapted to local conditions and institution-specific hygiene protocols.
The updated S1 guideline from the German Society of Anesthesiology and Intensive Care Medicine provides recommendations on hygiene practices for central and peripheral regional anesthesia procedures, aiming to minimize the infection risk for patients. Central to the guideline is the consistent implementation of standardized hygiene measures, with particular emphasis on thorough hand hygiene by the practitioners before and after each procedure. Patient skin preparation should be performed directly with remanent, alcohol-based disinfectants, provided there is no visible contamination. Hair removal is recommended only when necessary, preferably using clippers. For all neuraxial procedures, the use of a face mask, head cover, and sterile gloves is mandatory. In the case of single-shot peripheral nerve blocks, the use of non-sterile disposable gloves may be acceptable depending on the circumstances. Only sterile single-use materials and freshly withdrawn medications from single-dose containers should be used to prevent crosscontamination. In ultrasound-guided procedures, the use of a sterile probe cover and thorough disinfection of the ultrasound transducer before and after use are obligatory. For indwelling regional anesthesia catheters, the insertion site must be inspected daily; dressing changes should be performed only when infection is suspected or when there is an evident clinical indication. Catheter tunneling and the use of chlorhexidine-containing dressings may contribute to reducing bacterial contamination. If signs of infection occur, targeted diagnostics and infection-specific treatment should be initiated, according to the severity of the clinical presentation. Additionally, the guideline recommends the introduction of hygiene bundles, standardized procedural kits, and regular staff training. These measures should be subject to continuous evaluation and optimization via structured monitoring and benchmarking. All recommendations must be adapted to local conditions and institution-specific hygiene protocols.The updated S1 guideline from the German Society of Anesthesiology and Intensive Care Medicine provides recommendations on hygiene practices for central and peripheral regional anesthesia procedures, aiming to minimize the infection risk for patients. Central to the guideline is the consistent implementation of standardized hygiene measures, with particular emphasis on thorough hand hygiene by the practitioners before and after each procedure. Patient skin preparation should be performed directly with remanent, alcohol-based disinfectants, provided there is no visible contamination. Hair removal is recommended only when necessary, preferably using clippers. For all neuraxial procedures, the use of a face mask, head cover, and sterile gloves is mandatory. In the case of single-shot peripheral nerve blocks, the use of non-sterile disposable gloves may be acceptable depending on the circumstances. Only sterile single-use materials and freshly withdrawn medications from single-dose containers should be used to prevent crosscontamination. In ultrasound-guided procedures, the use of a sterile probe cover and thorough disinfection of the ultrasound transducer before and after use are obligatory. For indwelling regional anesthesia catheters, the insertion site must be inspected daily; dressing changes should be performed only when infection is suspected or when there is an evident clinical indication. Catheter tunneling and the use of chlorhexidine-containing dressings may contribute to reducing bacterial contamination. If signs of infection occur, targeted diagnostics and infection-specific treatment should be initiated, according to the severity of the clinical presentation. Additionally, the guideline recommends the introduction of hygiene bundles, standardized procedural kits, and regular staff training. These measures should be subject to continuous evaluation and optimization via structured monitoring and benchmarking. All recommendations must be adapted to local conditions and institution-specific hygiene protocols.
Author Göpfert, Matthias
Wiesmann, Thomas
Scheithauer, Simone
Steinfeldt, Thorsten
Heinen, Rebecca
Vicent, Oliver
Geffers, Christine
Schubert, Ann-Kristin
Döffert, Jens
Schulz-Stübner, Sebastian
Kessler, Paul
Wendt, Constanze
Volk, Thomas
Kubulus, Christine
Wulf, Hinnerk
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  surname: Wiesmann
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  email: wiesmant@staff.uni-marburg.de, wiesmant@staff.uni-marburg.de, wiesmant@staff.uni-marburg.de
  organization: Arbeitskreis Regionalanästhesie der DGAI, Nürnberg, Deutschland. wiesmant@staff.uni-marburg.de
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  givenname: Thomas
  surname: Volk
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  organization: Klinik f. Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland
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  surname: Heinen
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  organization: Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, BG Unfallklinik Frankfurt/Main, Friedberger Landstraße 430, 60389, Frankfurt/Main, Deutschland
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  givenname: Oliver
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  organization: Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus Dresden an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
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  givenname: Jens
  surname: Döffert
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– sequence: 6
  givenname: Sebastian
  surname: Schulz-Stübner
  fullname: Schulz-Stübner, Sebastian
  organization: Pädagogische Hochschule Freiburg, Freiburg i. Brsg., Deutschland
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  givenname: Christine
  surname: Geffers
  fullname: Geffers, Christine
  organization: Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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  givenname: Christine
  surname: Kubulus
  fullname: Kubulus, Christine
  organization: Klinik f. Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland
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  givenname: Paul
  surname: Kessler
  fullname: Kessler, Paul
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  givenname: Constanze
  surname: Wendt
  fullname: Wendt, Constanze
  organization: MVZ Labor Dr. Limbach & Kollegen eGbR, Im Breitspiel 16, 69126, Heidelberg, Deutschland
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  givenname: Simone
  surname: Scheithauer
  fullname: Scheithauer, Simone
  organization: Institut für Hygiene und Infektiologie, Universitätsmedizin Göttingen, Georg August Universität, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
– sequence: 13
  givenname: Hinnerk
  surname: Wulf
  fullname: Wulf, Hinnerk
  organization: Arbeitskreis Regionalanästhesie der DGAI, Nürnberg, Deutschland
– sequence: 14
  givenname: Thorsten
  surname: Steinfeldt
  fullname: Steinfeldt, Thorsten
  organization: Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, BG Unfallklinik Frankfurt/Main, Friedberger Landstraße 430, 60389, Frankfurt/Main, Deutschland
– sequence: 15
  givenname: Ann-Kristin
  surname: Schubert
  fullname: Schubert, Ann-Kristin
  organization: Arbeitskreis Regionalanästhesie der DGAI, Nürnberg, Deutschland
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Regional anesthesia
Epidural anesthesia
Hygiene
Spinal anesthesia
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SubjectTerms Anesthesia, Conduction - methods
Anesthesia, Conduction - standards
Anesthesiology - standards
Germany
Humans
Hygiene - standards
Societies, Medical
Title Hygiene recommendations for regional anesthesia : Updated S1 guidelines of the working group regional anesthesia of the German Society for Anesthesiology
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