Üşar Pınar, Kar Aysun Afife, Çıtak Güven, Maral Jale, Canlı Şeyda
Clinic of Anaesthesiology and Reanimation, Şifa University Hospital, İzmir, Turkey.
Clinic of Neurosurgery, Şifa University Hospital, İzmir, Turkey.
Turk J Anaesthesiol Reanim. 2015 Aug;43(4):282-4. doi: 10.5152/TJAR.2015.48902. Epub 2015 Feb 16.
The breakage of an epidural catheter, which is usually not noticed, is a rare but important complication encountered while inserting or removing the catheter during epidural blockade. While the epidural catheter was being inserted for labor analgesia, despite no problem being encountered in advancing the catheter, it was drawn back to verify the location; it was observed that 2 cm of the distal end of the catheter was missing. A neurosurgical consultation was requested; it was reported that the broken piece would not create any problems and reintervention could be performed for labor analgesia. An epidural catheter was reinserted and was used for analgesia without any problem until delivery. Although nine months have passed, no problem was defined by the patient. If epidural catheter has to be removed while the Tuohy needle is still in place, we recommend that they should be removed together to minimize the risk of a possible breakage. We think that the decision for surgery and imaging can be performed based on the individual patient's clinical picture.
硬膜外导管断裂通常不易被察觉，是硬膜外阻滞期间插入或拔出导管时罕见但重要的并发症。在为分娩镇痛插入硬膜外导管时，尽管导管推进过程中未遇到问题，但将其回撤以确认位置时，发现导管远端有2厘米缺失。于是请求神经外科会诊，报告称断裂部分不会造成任何问题，可重新进行分娩镇痛干预。重新插入一根硬膜外导管，直至分娩一直用于镇痛且未出现任何问题。尽管已经过去九个月，但患者未出现任何问题。如果在Tuohy针仍在位时必须拔出硬膜外导管，我们建议应将它们一起拔出，以尽量降低可能断裂的风险。我们认为，可以根据个体患者的临床表现来决定是否进行手术和影像学检查。
