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A case report of a retained and knotted caudal catheter

Caudal catheters advanced to the lumbar and thoracic regions can be used to provide excellent analgesia for pre-term neonates undergoing major abdominal and thoracic procedures. Despite their frequent use, attention to detail is mandatory to avoid complications related to the medications used or the...

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Autores principales: Joselyn, Anita, Bhalla, Tarun, Schloss, Brian, Martin, David, Tobias, Joseph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141403/
https://www.ncbi.nlm.nih.gov/pubmed/25191205
http://dx.doi.org/10.4103/1658-354X.136644
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author Joselyn, Anita
Bhalla, Tarun
Schloss, Brian
Martin, David
Tobias, Joseph
author_facet Joselyn, Anita
Bhalla, Tarun
Schloss, Brian
Martin, David
Tobias, Joseph
author_sort Joselyn, Anita
collection PubMed
description Caudal catheters advanced to the lumbar and thoracic regions can be used to provide excellent analgesia for pre-term neonates undergoing major abdominal and thoracic procedures. Despite their frequent use, attention to detail is mandatory to avoid complications related to the medications used or the placement technique. We present a 2-day-old, 2 kg, pre-term infant who was born at 32 weeks gestational age with a tracheoesophageal fistula. Following anesthetic induction, a caudal epidural catheter was placed with the intent of threading it to the mid-thoracic level. The intraoperative and post-operative courses were uneventful with the epidural catheter providing adequate analgesia without the need for supplemental intravenous opioids. During catheter removal, resistance was noted and it could not be easily removed. With repositioning and various other maneuvers, the catheter was removed with some difficulty. On examination of the catheter, a complete knot was noted. Options for catheter advancement from the caudal space to the thoracic dermatomes are reviewed and techniques discussed for removal of a retained epidural catheter.
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spelling pubmed-41414032014-09-04 A case report of a retained and knotted caudal catheter Joselyn, Anita Bhalla, Tarun Schloss, Brian Martin, David Tobias, Joseph Saudi J Anaesth Case Report Caudal catheters advanced to the lumbar and thoracic regions can be used to provide excellent analgesia for pre-term neonates undergoing major abdominal and thoracic procedures. Despite their frequent use, attention to detail is mandatory to avoid complications related to the medications used or the placement technique. We present a 2-day-old, 2 kg, pre-term infant who was born at 32 weeks gestational age with a tracheoesophageal fistula. Following anesthetic induction, a caudal epidural catheter was placed with the intent of threading it to the mid-thoracic level. The intraoperative and post-operative courses were uneventful with the epidural catheter providing adequate analgesia without the need for supplemental intravenous opioids. During catheter removal, resistance was noted and it could not be easily removed. With repositioning and various other maneuvers, the catheter was removed with some difficulty. On examination of the catheter, a complete knot was noted. Options for catheter advancement from the caudal space to the thoracic dermatomes are reviewed and techniques discussed for removal of a retained epidural catheter. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4141403/ /pubmed/25191205 http://dx.doi.org/10.4103/1658-354X.136644 Text en Copyright: © Saudi Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Joselyn, Anita
Bhalla, Tarun
Schloss, Brian
Martin, David
Tobias, Joseph
A case report of a retained and knotted caudal catheter
title A case report of a retained and knotted caudal catheter
title_full A case report of a retained and knotted caudal catheter
title_fullStr A case report of a retained and knotted caudal catheter
title_full_unstemmed A case report of a retained and knotted caudal catheter
title_short A case report of a retained and knotted caudal catheter
title_sort case report of a retained and knotted caudal catheter
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141403/
https://www.ncbi.nlm.nih.gov/pubmed/25191205
http://dx.doi.org/10.4103/1658-354X.136644
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