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Korean Journal of Anesthesiology 2008;55(4):494-497.
DOI: https://doi.org/10.4097/kjae.2008.55.4.494   
Accidental intrapleural positioning of an epidural catheter in a patient undergoing a right pneumonectomy: A case report.
Ji Yeon Kim, Jang Su Park, Chae In Jeong, Sang Il Lee, Kyung Tae Kim, Won Joo Choe, Jung Won Kim
Department of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea. jspark@paik.ac.kr
Thoracic epidural analgesia is a common method of pain relief for thoracic and upper abdominal surgery. Misplacement of the epidural catheter is one of the complications associated with epidural analgesia. A 60-year-old man was scheduled for a right pneumonectomy under general anesthesia. Before inducing general anesthesia, the patient was placed in the left lateral decubitus position. A 18-gauge Tuohy needle was inserted into the T6-T7 level using the left paramedian approach 1.5 cm lateral to the midline with a loss of resistance at 7 cm, and uneventful catheter advancement was performed. Approximately 30 minutes after commencing surgery, the surgeon found the epidural catheter in the right pleural cavity. We report a case of the accidental intrapleural positioning of a thoracic epidural catheter.
Key Words: complication; intrapleural positioning; loss of resistance; thoracic epidural catheter


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