FactFinders for patient safety: Minimizing injectate risks: Swabbing vial tops and preservative-free steroid formulations.

Authors

Reza Ehsanian, Clark C Smith, Vikaran Kadaba, Mathew Saffarian, Jaymin Patel, George Christolias, Mathew Paluck, David Levi, International Pain and Spine Intervention Society’s Patient Safety Committee

Published in

Interventional pain medicine. Volume 5. Issue 3. Pages 100804. Epub Aug 03, 2026.

Abstract

This series of Fact Finders presents a brief summary of the evidence and outlines recommendations regarding the injection of preservative-containing steroid formulations in the epidural space and the practice of swabbing newly opened vial tops before drawing up injectate. The evidence in support of the following facts is presented: (1) No adverse events have been documented from the administration of preservative-containing steroids into the epidural space; however, neurological injuries have been reported following intrathecal injection of these preservatives. (2) Swabbing newly opened vial tops before drawing up an injectate has been a standard procedure in healthcare settings. However, the evidence supporting its efficacy is mixed. While a recent study has found no significant benefit, guidelines from the American Society of Anesthesiologists (ASA), Centers for Disease Control and Prevention (CDC), and World Health Organization (WHO) still recommend this practice. (3) Greater than 60% isopropyl alcohol is not universally effective against all pathogens.

PMID:
42568862
Bibliographic data and abstract were imported from PubMed on 08 Aug 2026.

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