A lumbar epidural catheter placed for labor analgesia proved to be difficult to remove after an uneventful delivery. With the patient in the position of catheter insertion, i.e. seated, firm and steady traction allowed removal of the catheter and revealed a knot 4 mm from its tip. Passing excessive amount of catheter into the epidural space may have contributed to this complication. Guidelines to prevent and to minimize this complication are suggested.
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http://dx.doi.org/10.1016/j.ijoa.2005.07.003 | DOI Listing |
Cureus
March 2024
Anesthesiology, Ascension St. John Hospital, Detroit, USA.
Epidural catheters are seldom challenging to remove from patients. The occurrence of knotting in an epidural catheter, resulting in entrapment, is an uncommon complication of epidural catheterization. There is the risk of significant morbidity with a retained catheter, with the potential for infection or nerve injury.
View Article and Find Full Text PDFWorld J Clin Cases
April 2024
Anesthesia and Surgery Center, Dongguan Songshan Lake Central Hospital, Dongguan 523326, Guangdong Province, China.
Background: Combined spinal-epidural (CSE) anesthesia is the preferred anesthesia method for cesarean delivery. The use of an epidural catheter is essential for administering additional drugs intraoperatively and managing postoperative pain. However, the insertion of epidural catheters is associated with various complications, such as total spinal anesthesia, symptoms indicative of spinal nerve root irritation, and challenges in epidural catheter removal.
View Article and Find Full Text PDFAnesth Pain Med (Seoul)
July 2023
Department of Anesthesia and Critical Care, Nepal Mediciti, Lalitpur, Nepal.
Background: The knotting or in vivo entrapment of epidural catheters is an uncommon but challenging issue for anesthesiologists. This study aimed to identify the possible causes behind entrapped epidural catheters and the effective methods for their removal.
Methods: A systematic review of relevant case reports and series was conducted using the patient/population, intervention, comparison and outcome framework and keywords such as "epidural," "catheter," "knotting," "stuck," "entrapped," and "entrapment.
Arthrosc Tech
November 2020
AKB Center for Arthroscopy, Sports Injury and Regenerative Medicine. Lalitpur, Nepal.
Fixation over bone bridge is commonly performed during transosseous pullout knee surgeries. This technique requires the drilling of 2 bony tunnels separately. Herein, we describe our technique in which bone bridge fixation is performed with a single bony tunnel.
View Article and Find Full Text PDFMinim Invasive Surg
August 2020
Pediatric Surgery Department, Al-Azhar University, Cairo, Egypt.
Background: Single-incision percutaneous closure (SIPC) of pediatric inguinal hernia under laparoscopic guidance is a well-developed feasible technique; however, suture knotting remains a major challenge during this technique. Most laparoscopic surgeons prefer extracorporeal subcutaneous suture knotting, which may be associated with consequent formation of stitch sinus and increased recurrence rate. On the other hand, intracorporeal suture knotting necessitates the availability of special devices or homemade instruments with a long learning curve.
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