Accidental subarachnoid position of an epidural catheter

Authors

DOI:

https://doi.org/10.25751/rspa.20577

Keywords:

epidural, subarachnoid, analgesia, chronic pain

Abstract

Epidural analgesia remains a frequently used technique in all perioperative settings and chronic pain management, though still associated with a variety of complications, including technique failure, spinal hematoma or abcess and inadvertent location/migration of the catheter to the intravascular/subdural/subarachnoid space, with potential letal consequences.

In this clinical case we report a migration of an epidural catheter intended for chronic pain management, which was placed intrathecally with position confirmed by radiocontrast dye. The authors pretend to highlight with this case that a high suspicion level is crucial for the correct diagnosis of catheter malposition and appropriate management. In our current knowledge, there are no previous published images on the literature showing simultaneous radiocontrast in both the epidural and intratechal space, giving our imagens its singularity.

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References

1- Mateo E, López-Alarcón MD, Moliner S, Calabuig E, Vivó M, De Andrés J, Grau F. Epidural and subarachnoidal pneumocephalus after epidural technique. EJA, 1999; 16: 413-417
2- Jaeger M, Modsen M. Delayed subarachnoid migration of an epidural arrow flexes tip plus catheter. Anesthesiology; 1997, 87:719-20
3- Mishra P, Bhakta P, Janakiraman R, Darlong V. Intra-operative epidural catheter migration into subarachnoid space leading to massive subarachnoid injection of morphine.M.E.J. Anesth, 2009; 20: 3
4- E.N.Armitage, Lumbar and thoracic epidural anaesthesia. In: JAW Wildsmith, Edward N. Armitage, editors, Principles & Practice of Regional Anaesthesia Edinburgh; Churchill Livingstone, 1987; 87: 98

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Published

2021-04-07

How to Cite

Cunha, A. S., & Nunes Marques, J. F. (2021). Accidental subarachnoid position of an epidural catheter. Journal of the Portuguese Society of Anesthesiology, 30(1). https://doi.org/10.25751/rspa.20577

Issue

Vol. 30 No. 1 (2021): Revista da Sociedade Portuguesa de Anestesiologia

Section

Case Report

License

Copyright (c) 2021 Ana Sofia Cunha, João Filipe Nunes Marques

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