Severed Epidural Cath

Started by yogenbhatt1, June 20, 2008, 02:07:55 AM

Previous topic - Next topic

0 Members and 1 Guest are viewing this topic.

yogenbhatt1

Managed to break an epidural cath. Gave spinal and came out. Informed the surgeon. Finished the surgery ( IT #) and closed the chapter. It is now about 6 years. We have not heard from them since then. What all can happen is anybody's guess.
Either way let us have guesses.
A team had informed the surgeon and they opened up the spine and never found the cath piece. Is surgery an option to remove it?
Would CT or MRI show the cath?
Let us here it.

jafo1964

Surgical exploration is not mandatory for asymptomatic patient.
Surgeon and patient just has to be informed and documentation
Close monitoring for neurological deficit.

If problem arises MRI should be OK followed by surgical exploration

Catheters get severed when we try and withdraw them through the needle and not in toto as a set. All of us know this complication but it is so rare that we seldom follow it ( ME INCLUDED).
Rarely when we get into trouble after years of practice like this we indeed realise that it was all written in the textbooks in the first place.

I wonder why inspite of knowing what is safe, sometimes we ( ME INCLUDED) never follow it

Would like to hear your views on it

regs

yogenbhatt1

#2
Hi,
You asked, why we ingnor our basic teachings?
The reply is simple. When we introduce a needle and guide wire for IJV, we remove it in toto as you mentioned. You can always try agian here, or even the other side and site.
But, for Epidural, we do not remove the needle, though we know that it can severe the cath. To start with, it is not easy to locate the space, specially in elderly, obese, inferior ext fracture cases ( as they can't sit properly), and very tensed ppl, or labour analgesia, as they do not allow us easily. We pull the cath because we know that the needle is in the right place after all this difficulty, now the cath is to be repositioned.
Honestly, we try to get away with it, but do get trapped, and then we remember our books and teachings.
Regards.
Dr. Bhatt