Determination of ChloraPrep® drying time before neuraxial anesthesia in elective cesarean delivery. A prospective observational study. (May 2019) - Gunka, V.
Highlights: ChloraPrep® is a skin antiseptic commonly used before neuraxial anesthesia. No evidence-based ChloraPrep® drying time guidelines exist. ChloraPrep® drying time was measured in 18 elective cesarean deliveries. The longest measured ChloraPrep drying time was 195 seconds. Abstract: Background: ChloraPrep® is a skin antiseptic commonly used before neuraxial anesthesia. It is believed that skin must be allowed to dry to prevent nerve damage by seeding ChloraPrep® solution into the neuraxis. We aimed to determine ChloraPrep® drying time in pregnant women before initiation of neuraxial anesthesia. Methods: In 18 parturients undergoing elective cesarean delivery the skin 'wetness' after standardized ChloraPrep® application was prospectively assessed by blotting the skin with tissue paper and observing for residual orange tint. The isopropyl alcohol drying time was indirectly assessed by measuring the alcohol vapor concentration above the skin with a volatile organic compound analyzer. The primary outcome was the time measured from the end of skin preparation until tissue paper was no longer stained with orange tint. The secondary outcome was the time measured from the end of skin preparation until an abrupt reduction of isopropyl alcohol vapor concentration indicating that no further significant evaporation of alcohol was occurring. Results: The mean ChloraPrep® drying time assessed by blotting the skin with tissue paper was 123 s (SD 32 s, 95% CI 107 to 140 s, range 85–195 s). The estimated isopropyl alcohol drying time was 82 s (95% CI 77.4 to 86.3 s). Conclusion: Our results suggest that ChloraPrep® drying time may be longer than the current manufacturer-recommended guideline of three minutes. The amount of ChloraPrep® used, application methods, patient characteristics, and environmental factors could influence the drying time.