Management of a ruptured epidural catheter, an anesthesiologist's dilemma: a case report
DOI:
https://doi.org/10.18203/2320-6012.ijrms20205414Keywords:
Epidural anesthesia, Broken epidural catheter, Broken needle, Neuraxial block, HemilaminectomyAbstract
Epidural anesthesia is a widely used anesthetic technique in lower extremity surgeries although it is a relatively safe procedure, it can have complications, such as rupture of the epidural catheter. This is a 69-year-old male patient with a diagnosis of Wagner IV diabetic foot is presented, which was scheduled for left supracondylar amputation in which after epidural block, retention of the catheter tip in the epidural space at level L2-L3 was seen, so hemi laminectomy was performed in a second surgical stage in L2 and removal of the epidural catheter. Ideally a broken needle should be removed as soon as possible.
References
Esqueda-Arriaga MA, Martínez-Arriaga GJ. Extracción quirúrgica de catéter peridural retenido. Reporte de un caso. Revista Mexicana de Anestesiología. 2009;32:191-5.
Mireles-Cano JN, Andrade-Aguilar CI, García-González OG, Orozco-Ramírez SM, Arévalo-Rivas BI. Extracción quirúrgica de fragmento de catéter en espacio epidural. Reporte de un caso y revisión de la literatura. Revista Mexicana de Anestesiología. 2014;37(2):113-9.
Hippalgaonkar AV, Kudalkar AG, Gaikwad SM, Modak S, Gupta HB, Tendolkar BA. Successful management of a broken epidural catheter. Saudi J Anaesth. 2017;11:228-31.
Eckmann DM. Variations in Epidural Catheter Manufacture: Implications for Bending and Stiffness. Reg Anesth Pain Med. 2003;28:37-42.
Karkhanis D, Bajaj JS, Kane D Managing a Broken Epidural Catheter: Conundrum for an Anaesthetist. JCR. 2020;10:64-7.
Mitra R, Fleischmann K. Management of the sheared epidural catheter: is surgical extraction really necessary? J Clin Anesth. 2007;19(4):310-4.
Martinello C, Rubio R, Hurwitz E. Broken spinal needle: case report and review of the literature. J Clin Anesth. 2014;26:321-4.
Moll A, Filippini G. Ruptura de aguja espinal. ATOTW. 2018;1-5.
De Filho G, Gomes H, da Fonseca M. Predictors of successful neuraxial block: a prospective study. Eur J Anaesthesiol. 2002;19(6):447-51.
Román JA, Reina MA, López A, Fernández MS, Escobar JM. Atrapamiento de un catéter epidural, reconstrucción de imágenes de tomografía computarizada. Revista Española de Anestesiología y Reanimación. 2008;55:640-3.
Sbardelotto C, Matsumoto M, da Rocha R, Almeida R. Quebra de cateter no espaço / peridural breakage of a catheter in the epidural space. Revista Brasileira de Anestesiologia. 2008;58:227-33.
Esqueda-Arriaga MA, Martínez-Arriaga GJ. Extracción quirúrgica de catéter peridural retenido. Reporte de un caso. Revista Mexicana de Anestesiología. 2009;32:191-5.
Gómez-Menendez JM, Marín A. Problemas con el retiro de dos catéteres epidurales tipo Arrow Flex Tip en el espacio epidural lumbar. Revista Colombiana de Anestesiología y Sociedad Colombiana de Anestesia y Reanimación. 2003;41:201-3.