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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

996
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
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The unexpected epidural: a case report.

Riccardo Pinciroli1,2, Roberto Fumagalli3,4

  • 1Department of Anesthesia and Critical Care, Anesthesia and Critical Care Service 1, Niguarda Cà Granda Hospital, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy. riccardo.pinciroli@gmail.com.

BMC Anesthesiology
|June 5, 2015
PubMed
Summary
This summary is machine-generated.

A large epidural catheter fragment was incidentally discovered 12 years after placement in an asymptomatic patient. This case highlights how retained epidural fragments can go undetected, potentially leading to delayed diagnosis of complications.

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Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Radiology

Background:

  • Epidural catheterization is a common procedure for pain management.
  • Catheter breakage and fragment retention are known, albeit rare, complications.
  • Such retained fragments can remain asymptomatic and undetected for extended periods.

Observation:

  • A 53-year-old female presented with peritonitis after sigmoidectomy.
  • An incidental finding on X-ray revealed a filiform metallic object.
  • The object was traced back to an epidural catheter placed 12 years prior during pregnancy.

Findings:

  • A 15 cm fragment of a wire-reinforced epidural catheter was retained.
  • The patient was completely asymptomatic with no prior knowledge of the retained fragment.
  • The fragment was present on preoperative imaging for a recent surgery, initially misidentified.

Implications:

  • Retained epidural catheter fragments can be asymptomatic for years.
  • Incidental discovery of large retained fragments is possible.
  • Delayed identification of retained fragments can complicate diagnosis and treatment of potential sequelae.