• David Anthony Provenzano, Michael Hanes, Christine Hunt, Honorio T Benzon, Jay S Grider, Kelly Cawcutt, Tina L Doshi, Salim Hayek, Bryan Hoelzer, Rebecca L Johnson, Hari Kalagara, Sandra Kopp, Randy W Loftus, MacfarlaneAlan James RobertAJR0000-0003-3858-6468Glasgow Royal Infirmary and Stobhill Ambulatory Hospital, Glasgow, UK.University of Glasgow, Glasgow, UK., Ameet S Nagpal, Stephanie A Neuman, Amit Pawa, Amy C S Pearson, Julie Pilitsis, Eellan Sivanesan, Rakesh V Sondekoppam, Jan Van Zundert, and Samer Narouze.
• Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania, USA davidprovenzano@hotmail.com.
• Reg Anesth Pain Med. 2025 Feb 11.

BackgroundTo provide recommendations on risk mitigation, diagnosis and treatment of infectious complications associated with the practice of regional anesthesia, acute and chronic pain management.MethodsFollowing board approval, in 2020 the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) commissioned evidence-based guidelines for best practices for infection control. More than 80 research questions were developed and literature searches undertaken by assigned working groups comprising four to five members. Modified US Preventive Services Task Force criteria were used to determine levels of evidence and certainty. Using a modified Delphi method, >50% agreement was needed to accept a recommendation for author review, and >75% agreement for a recommendation to be accepted. The ASRA Pain Medicine Board of Directors reviewed and approved the final guidelines.ResultsAfter documenting the incidence and infectious complications associated with regional anesthesia and interventional pain procedures including implanted devices, we made recommendations regarding the role of the anesthesiologist and pain physician in infection control, preoperative patient risk factors and management, sterile technique, equipment use and maintenance, healthcare setting (office, hospital, operating room), surgical technique, postoperative risk reduction, and infection symptoms, diagnosis, and treatment. Consensus recommendations were based on risks associated with different settings and procedures, and keeping in mind each patient's unique characteristics.ConclusionsThe recommendations are intended to be multidisciplinary guidelines for clinical care and clinical decision-making in the regional anesthesia and chronic interventional pain practice. The issues addressed are constantly evolving, therefore, consistent updating will be required.© American Society of Regional Anesthesia & Pain Medicine 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.

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