TITLE:
Management of a Retained Epidural Catheter in a Pregnant Patient: A Case Report and Review of Literature
AUTHORS:
Kevin W. Tang, Mingzhuo Pei, Aamod George, Antoine Anderson, Ming Xiong
KEYWORDS:
Epidural, Obstetric Anesthesia, Neuraxial Anesthesia, Retained Catheter, Computed Tomography
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.14 No.8,
August
30,
2024
ABSTRACT: Background: Epidural anesthesia is an effective intervention to treat labor pain and provide analgesia for orthopedic procedures. A rare complication of this technique is epidural catheter retention. Case Presentation: In this case report, we present an otherwise healthy 21-year-old G2P0010 woman at 39 weeks and 3 days gestation whose anesthetic management was complicated by a symptomatic retained epidural catheter fragment. Computed tomography (CT) imaging of her spine showed the fractured catheter within her paraspinal muscles and neurosurgery recommended no surgical intervention at that time. The patient reported resolution of back pain while in the postpartum unit which she continues to endorse two weeks after discharge. Conclusion: Retained epidural catheter is a medical emergency that requires immediate imaging and neurological evaluation. While magnetic resonance imaging is typically regarded as the standard imaging modality for this complication, in epidural sets that contain metallic components, we suggest using CT to avoid the risk of thermal nerve damage. In cases where the patient does not report any acute complaints, nonsurgical management may be appropriate but close follow-up is required to monitor for catheter migration.