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Migration of thoracic epidural catheters. Three methods for evaluation of catheter position in the thoracic epidural
J Mourisse1, M J Gielen, M A Hasenbos
1Department of Anaesthesia, St Radboudhospital, Nijmegen, The Netherlands.
Abstract:
Migration of thoracic epidural catheters was evaluated in 25 patients by three methods either after placement of the catheter or immediately after surgery. The first method was the determination of the depth of the catheter from the skin, the second the determination of the level of sensory blockade which resulted from a test dose of a local anesthetic agent, while the third consisted of radiological visualisation of the catheter tip in the epidural space with radiopaque dye. The evaluations were repeated on the third or fourth day after operation. We observed an inward movement of the catheter in 56% of the patients instead of the expected outward movement. This inward movement was accompanied by a higher level of sensory blockade. No relationship with radiological visualisation was found.