Was there a retained spinal catheter?

The 28-gauge catheter supplied by Kendall Healthcare Products Company (Mansfield, MA) for continuous spinal anesthesia has two important characteristics. The ink used for the centimeter calibration marks and to identify the tip of the catheter "washes off" while it is inserted in the patient. In addition, the catheter has a tendency to stretch while it is in the patient or being removed. These two characteristics produced a situation in which it was impossible to determine whether a catheter fragment had been left in a patient. This predicament had a serious impact on the postoperative management of the patient. A computerized tomographic scan and spine films were negative, while other evidence suggested that a fragment was left behind. When the patient developed a postdural puncture headache, the authors felt that an epidural blood patch was contraindicated. The patient's headache did resolve with 48 hours of conservative therapy.