Cateter epidural

Indian Journal of Anaesthesia 2007; 51 (5) : 434-437

Case Report
Indian Journal of Anaesthesia, October 2007

Epidural Catheter Breakage:A Dilemma
Deepanjali Pant1, Pradeep Jain 2, Pravesh Kanthed3 , Jayashree Sood4
Summary
Placement of an epidural catheter in epidural space is a routine practice for providing anaesthesia/analgesia in a myriad of surgical procedures and various painful conditions. Breakage of an epidural catheter, though rare, is a well-known complication.
We present a case report of such an event and a comprehensive review of do’s and don’ts in this setting.

Key words

Epidural catheter, Breakage, Management.

Introduction
A broken spinal or epidural catheter, although an uncommon occurrence, remains an area of utmost dilemma to the practising anaesthesiologist. While the insertion of a spinal or epidural catheter is usually safe, they have been known to break during removal, leaving a segment lodged in patient’s back.1 Since surgical removal of a broken catheter is not recommended and the severed nonbiodegradable catheter is situated in an anatomical region which does not permit it to be naturally extruded, it is left in the patient permanently. 2 The discomfort to the patient and the formidable complication that may rarely result from such a mishap could greatly deter surgeons, anaesthesiologists and patients from this most useful anaesthetic technique. .

relocate the epidural space. While the catheter was being removed with gentle traction along with Tuohy needle, it sheared off at 6 cm mark. (Fig.1)

Case report
A 70 -yr - old, 65 kg male, presented with history of road traffic accident leading to multiple rib fractures on right side. He was a known case of COPD, on intermittent bronchodilator therapy. Due to severe pain related to rib fracture, the patient was unable to cough out secretions effectively. He was referred to acute pain services for pain relief.

Fi g.1 Epidural catheter-broken at 6 cm