ABSTRACT
We report a removal difficulty of a stuck epidural catheter between the lomber vertebral facets. An epidural catheter was inserted for perioperative pain management before general anesthesia to a woman undergoing laparatomy for oopherectomy. A lomber epidural catheterization was performed with 18- gauge needle using midline approach in left lateral position. Following a test dose general anesthesia was commenced. After extubation, patient has reported a severe abdominal pain which revealed an incomplete epidural analgesia. Therefore removal of the epidural catheter was decided. As all the removal attempts were failed, a CT scan evaluation which revealed catheter stuck between the left interfacet junctions of the L2-L3 vertebrae, was performed. This is an uncommon cause of catheter stuck. None of the recommended maneuvers worked in this stuck catheter case. Therefore iv midazolam and removal attempt in right lateral position with the legs flexed and vertebra flexed and rotated contralaterally, was decided. This approach was successful for the removal of the catheter.
Keywords:
Epidural catheter, epidural anesthesia, computerized tomography.VOLUME
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