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///2015 Abstract Details
2015 Abstract Details2019-08-02T16:54:43-05:00

Measurement of ChloraPrep® Drying Time before Neuraxial Anesthesia in Elective Cesarean Delivery. Prospective Observational Study

Abstract Number: F-66
Abstract Type: Original Research

Parisa Soltani MD 1 ; George Astrakianakis BEng MEng PhD2; Mark Martinez PhD3; Trevor Kavanagh MB. BCh, BAO, FCAI, FRCPC4; Alison Dube BSc5; Vit Gunka MD FRCPC6

Measurement of ChloraPrep® Drying Time before Neuraxial Anesthesia in Elective Cesarean Delivery. Prospective Observational Study

Authors: Dr Parisa Soltani, Dr George Astrakianakis, Dr Mark Martinez, Dr Trevor Kavanagh, Ms. Alison, Dr Vit Gunka

Background

ChloraPrep® is a skin antiseptic commonly used before neuraxial anesthesia. It contains 2% chlorhexidine gluconate (CHG), 70% isopropyl alcohol (IPA), water, and an orange tint. CHG and IPA are neurotoxic.1 To avoid nerve damage, ChloraPrep® must be allowed to dry before the skin is punctured. The aim of this study was to measure ChloraPrep® skin drying time and to determine IPA drying time.

Methods

ChloraPrep® drying time was assessed in 18 consenting parturients before elective cesarean delivery. The ChloraPrep® applicator was weighted pre and post use. In the operating room, one researcher applied antiseptic evenly over a standardized area. Skin dryness was assessed by blotting the perimeter of the preparation area with tissue paper at 15-second intervals and observing for disappearance of the orange tint staining. IPA vapor concentration was measured continuously 1 cm above the center of the preparation area with a volatile organic compound analyzer (ppbRAE 3000, USA). Using linear breakpoint regression analysis, the onset of the plateau on the IPA evaporation curve was arbitrarily defined as ‘IPA drying time’.

Results

ChloraPrep® drying time measured by blotting was 123 s (SD 32, 95%CI 107-140). The estimated IPA drying time was between 82 and 99 seconds. The mean ChloraPrep® amount applied was 1 g (SD 0.3).

Discussion

Our data supports waiting for at least 2 minutes after ChloraPrep® application to ensure skin dryness and to avoid seeding potentially neurotoxic agents deep into tissues. Copious ChloraPrep® application, presence of skin folds, and excessive lumbar hair may require a longer drying period.

Reference

1. Bogod D. The sting in the tail: antiseptics and the neuraxis revisited. Anaesthesia. 2012:1305-9



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