Misplacement of Epidural Catheter Confirmed by Epidurography. |
Jin Woo Shin, In Cheol Choi, Cheong Lee |
Department of Anesthesiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. |
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Abstract |
Epidural anesthesia is a reliable technique of conduction anesthesia that is not temporally limited and provides profound relaxation. Epidural anesthesia, even in skilled hands, has a failure rate as high as 8%. Technical difficulties may result from abnormalities of the vertebral column and bands or sheaths within the epidural space.
Furthermore, kinking, knots, and misplaced epidural catheters may cause incomplete or absent anesthesia. A flexible cannula passed into the epidural space cannot be relied upon to travel for any distance according to the direction of the bevel of the Tuohy needle. Only about one in four cannulas pursues a straight upward course within the epidural space. We describe accidental pass out of epidural space through an intervertebral foramen. A 72-years old man was scheduled for open prostatectomy under epidural anesthesia. The epidural catheter was placed in standard fashion without difficulty or indication of catheter rnalposition but epidural anesthesia was failed. Operation was taken under general anesthesia. At the end of the operation epidurography of the lumbar spine was taken. The epidurography showed that the catheter passed out of epidural space through an intervetebral foramen. |
Key Words:
Epidural anesthesia; Catheter; Intervertebral foramen |
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