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Knot formation in a thoracic epidural catheter: a case report
Toshiyuki Mizota1, Kayo Kimura2, Chikashi Takeda2
1Department of Anesthesia, Kyoto University Hospital, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan. mizota@kuhp.kyoto-u.ac.jp.
JA Clinical Reports
|June 8, 2021
Summary
Knot formation in thoracic epidural catheters is rare but can occur. Limiting catheter insertion depth may help prevent this complication during epidural anesthesia.
Area of Science:
- Anesthesiology
- Neurosurgery
- Medical Devices
Background:
- Knot formation is a known complication of epidural catheter placement.
- Most reported cases involve lumbar epidural catheters.
- This case highlights the possibility of knotting in thoracic epidural placement.
Purpose of the Study:
- To report a rare case of thoracic epidural catheter knot formation.
- To discuss potential preventative measures for epidural catheter knotting.
Main Methods:
- A 72-year-old female patient received thoracic epidural anesthesia for laparoscopic cholecystectomy.
- The epidural catheter was inserted 7 cm into the thoracic epidural space.
- Difficulty in catheter removal prompted investigation, revealing a knot near the tip.
Main Results:
- A single, hard knot was found 3 mm from the tip of the removed thoracic epidural catheter.
- The catheter was successfully removed with patient repositioning and gentle traction.
- The event occurred two days post-surgery.
Conclusions:
- Thoracic epidural catheter knot formation is a potential complication.
- Limiting the depth of catheter insertion may reduce the risk of knotting.
- Awareness and careful technique are crucial in preventing epidural catheter complications.
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