[A case of neural injury by defective epidural needle]

A 70-year-old man who had undergone an elective transverse colectomy developed neural injury caused by defective epidural needle. The stylet of the 17-gauge disposable Tuohy needle used consisted of two components. The tip of the stylet was made of teflon and the material of the body was steel. The needle was inserted at Th 11-12, Th 10-11 and Th 9-10 interspaces utilizing the loss of resistance method with saline, but all the trials resulted in failure to identify needle entry into the epidural space. The patient complained of fatigue in his right lower extremity and the blood pressure was elevated to 235/125 mmHg during the series of the needle placement. The cause of the failure was finally found to be complete obstruction of the needle with a small piece torn from the stylet tip. Right femoral pain, right instep hypesthesia and muscle weakness in the right leg remained after the operation. These symptoms gradually improved and he left the hospital with slight hypesthesia remaining in his right instep 42 days after the operation.