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June 2010, Volume 40 Number 6 , p 62 - 63


  • Clifford Gevirtz MD, MPH


FOLLOWING BASIC INFECTION control procedures should be routine in pain management, but reusing syringes, contaminating multidose vials, and breaking sterile technique are all reported with regularity. (See Pointers for safe practice for infection-control tips.) This article describes infection control issues with implanted pain management devices such as spinal cord stimulators or epidural or intrathecal drug-delivery systems, with or without a subcutaneous port. Implanted drug-delivery systems can be used to administer intrathecal analgesics over long periods at home for treating refractory cancer pain.The National Surgical Infection Prevention Project has guidelines for preoperative antibiotic prophylaxis for surgical patients.1 Because of the possibility of catastrophic infection, routine antimicrobial prophylaxis is recommended for all patients receiving a spinal cord stimulator or implanted intrathecal drug-delivery system. Cefazolin, clindamycin, and vancomycin are the drugs of choice;

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