Literature DB >> 22701224

Re: A rare complication of epidural anaesthesia. A case report with brief review of literature.

Adriano Bs Hobaika1.   

Abstract

Entities:  

Year:  2012        PMID: 22701224      PMCID: PMC3371508          DOI: 10.4103/0019-5049.96315

Source DB:  PubMed          Journal:  Indian J Anaesth        ISSN: 0019-5049


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Sir, I read with interest the article titled, “A rare complication of epidural anaesthesia a case report with brief review of literature” by Lala et al.[1] The authors cite some methods to remove a catheter with increased resistance. It is interesting to note that there are some other recommendations to prevent the breakage of an epidural catheter.[2] Removal should always be performed by an anaesthesiologist or trained personnel because, in two cases, the catheter broke when non-trained personnel removed the catheter.[34] Removal should be done cautiously, applying continuous force, avoiding the use of excessive force. Prehension devices, such as haemostatic forceps, should never be used. The patient should be positioned in lateral decubitus for an easier removal. When facing a difficult catheter removal, one can inject normal saline through the catheter before another attempt.[56] Some authors recommend waiting 30–60 min before another attempt. Although this conduct lacks a logical explanation, it was effective in two cases of difficult catheter removal.[78] The experience of pain during the removal might indicate that the catheter is tangled around a nerve root. Because of the possibility of nerve root avulsion, the catheter should be removed under direct visualization through a laminectomy. In one case of a difficult catheter removal, a sterile Tuohy needle was introduced in the epidural space using the catheter as a guide; the needle and the catheter were removed as one set. Although this method was successful in the case described, it has a clear risk of catheter breakage and, therefore, this technique is not recommended.[9]
  9 in total

1.  Breakage of epidural catheters: a comparison of an arrow reinforced catheter and other nonreinforced catheters.

Authors:  T Asai; K Yamamoto; T Hirose; H Taguchi; K Shingu
Journal:  Anesth Analg       Date:  2001-01       Impact factor: 5.108

2.  Decreased tensile strength of an epidural catheter during its removal by grasping with a hemostat.

Authors:  I Nishio; M Sekiguchi; Y Aoyama; S Asano; A Ono
Journal:  Anesth Analg       Date:  2001-07       Impact factor: 5.108

3.  Removal of a tenacious epidural catheter.

Authors:  F Gadalla
Journal:  Anesth Analg       Date:  1992-12       Impact factor: 5.108

4.  Subcutaneous effusion resulting from an epidural catheter fragment.

Authors:  Y Demiraran; I Yucel; B Erdogmus
Journal:  Br J Anaesth       Date:  2006-02-13       Impact factor: 9.166

Review 5.  Breakage of epidural catheters: etiology, prevention, and management.

Authors:  Adriano Bechara de Souza Hobaika
Journal:  Rev Bras Anestesiol       Date:  2008 May-Jun       Impact factor: 0.964

6.  A simple method to retrieve irretrievable epidural catheters.

Authors:  T R Shantha; M Mani
Journal:  Anesth Analg       Date:  1991-10       Impact factor: 5.108

7.  Knotting of an epidural catheter: a case report.

Authors:  R A Browne; V L Politi
Journal:  Can Anaesth Soc J       Date:  1979-03

8.  An entrapped epidural catheter in a postpartum patient.

Authors:  E F Jongleux; R Miller; A Freeman
Journal:  Reg Anesth Pain Med       Date:  1998 Nov-Dec       Impact factor: 6.288

9.  A rare complication of epidural anaesthesia a case report with brief review of literature.

Authors:  Parvez S Lala; V Langar; A Rai; R Singh
Journal:  Indian J Anaesth       Date:  2011-11
  9 in total

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