Knotting of an epidural catheter: a rare complication.

Knotting of an epidural catheter leading to entrapment is a rare complication of epidural catheterization. A lumbar epidural catheter inserted in a 28-year-old woman for caesarean section anesthesia and postoperative analgesia proved difficult to remove. After multiple attempts and placing the patient in the same position as when the catheter was initially inserted, the entrapped catheter was dislodged intact, revealing a double knot near its distal tip. Leaving catheters of less than 4 cm in length in the epidural space may help to avoid this complication. It is important the patient be informed of the techniques involved in the extraction of the resistant catheter because patient's cooperation is important for the nonsurgical removal of an entrapped epidural catheter.