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[A sheared off and sequestered epidural catheter: a case report]
Noriko Sakuma1, Masaki Hori, Hirotoshi Suzuki
1Department of Anesthesia, Senen Sogo Hospital, Tagazyo 985-0842.
Masui. the Japanese Journal of Anesthesiology
|March 12, 2004
Summary
A 10.6 cm segment of epidural catheter was retained after combined spinal-epidural anesthesia. Electron microscopy revealed the fragment was likely sheared by the Tuohy or spinal needle during placement.
Area of Science:
- Anesthesiology
- Medical Device Technology
- Surgical Complications
Background:
- Combined spinal-epidural anesthesia is a common technique for surgical procedures.
- Proper catheter placement is crucial to avoid complications.
- Polyethylene epidural catheters are frequently used in anesthesia.
Observation:
- A segment of a 20-G polyethylene epidural catheter was retained post-procedure.
- The retained fragment measured approximately 10.6 cm.
- The catheter was inserted using a 17-G Tuohy needle and a 25-G spinal needle.
Findings:
- The retained catheter fragment was successfully removed via a small incision under local anesthesia.
- Electron microscopy indicated mechanical trauma to the catheter.
- The trauma likely occurred due to interaction with the Tuohy or spinal needle during insertion.
Implications:
- This case highlights a rare complication of retained epidural catheter fragments.
- Careful technique and appropriate needle/catheter size selection may prevent such incidents.
- Understanding the mechanism of catheter shearing is important for improving patient safety.