Case Report – Accidental Epidural Catheter Breakage and Its Management
Karuna Taksande
Department of Anesthesia, JNMC, DMIMS, Sawangi, Wardha, Maharashtra, India.
Krishnendu S. *
Department of Anesthesia, JNMC, DMIMS, Sawangi, Wardha, Maharashtra, India.
Nikhil Bhalerao
Department of Anesthesia, JNMC, DMIMS, Sawangi, Wardha, Maharashtra, India.
Jui Jadhav
Department of Anesthesia, JNMC, DMIMS, Sawangi, Wardha, Maharashtra, India.
Dnyanashree Wanjari
Department of Anesthesia, JNMC, DMIMS, Sawangi, Wardha, Maharashtra, India.
Aditi Shatalwar
Department of Anesthesia, JNMC, DMIMS, Sawangi, Wardha, Maharashtra, India.
*Author to whom correspondence should be addressed.
Abstract
Aim: Epidural anaesthesia which is preferred in most of the prolonged and painful procedures can be dreadful when the catheter breaks inside. In this case report we report accidental breakage of epidural catheter and its successful management.
Presentation of Case: 47 year old male patient was posted for arthroscopic Anterior cruciate ligament (ACL) and Posterior Cruciate Ligament (PCL) repair under spinal and epidural anesthesia. Epidural catheter got sheared while securing it. It was managed by surgical removal to avoid further complications.
Discussion: There are different causes for epidural catheter breakage including technical error and manufacture error. Catheter should be checked for any manufacturing defect or kinking. If there is resistant while inserting the catheter careful removal of catheter along with the needle should be performed to avoid breakage of catheter.
Conclusion: Epidural catheter breakage can be disastrous for any anaesthesiologist, so it is important to be vigilant while securing epidural catheter. If accidentally epidural catheter is retained it should be discussed with the patient and surgeons, and it is either removed since it is a foreign body or if left in situ. Serial follow-up for any neurological symptoms should be done.
Keywords: Epidural catheter breakage, retained epidural catheter, fracture epidural catheter, sheared epidural catheter