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Epidural catheter malposition in a failed epidural anesthesia confirmed by computed tomography
Se Jin Lee1, Sang Ho Kim, Sun Young Park
1Department of Anesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea.
The Korean Journal of Pain
|March 11, 2011
Summary
Failed epidural anesthesia occurred despite standard techniques. Computed tomography revealed accidental T2 lamina catheter placement, highlighting the need for imaging guidance to improve success and safety.
Area of Science:
- Anesthesiology
- Neurosurgery
- Radiology
Background:
- Epidural anesthesia is a common procedure for pain management.
- Standard techniques like loss of resistance and hanging drop method are typically used to confirm epidural space entry.
Observation:
- A case of failed epidural anesthesia is presented despite the successful use of standardized techniques.
- Computed tomography (CT) was employed to verify epidural catheter placement.
Findings:
- CT imaging confirmed the epidural catheter was inadvertently positioned at the T2 lamina.
- This malpositioning explains the failure of the epidural anesthesia despite apparent procedural success.
Implications:
- The findings suggest that even with standardized techniques, epidural catheter placement can be inaccurate.
- Fluoroscopic guidance during epidural procedures is recommended to enhance accuracy, success rates, and patient safety.
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