Inadvertent Knot Formation on a Lumbar Epidural Catheter: A Rare Complication
Ricardo Serna-Muñoz *
The American British Cowdray Medical Center, Mexico City, Mexico.
Roberto Jimenez-Contreras
The American British Cowdray Medical Center, Mexico City, Mexico.
Jose Eduardo Etulain-Gonzalez
The American British Cowdray Medical Center, Mexico City, Mexico.
Ana Cristina Gonzalez-Estavillo
The American British Cowdray Medical Center, Mexico City, Mexico.
Mario Sánchez Franco MD
The American British Cowdray Medical Center, Mexico City, Mexico.
*Author to whom correspondence should be addressed.
Abstract
The knotting of an epidural catheter is an unusual complication that can result in disfunction of the catheter, difficult removal and may require surgical management.We report a case of knot formation on a lumbar epidural catheter, introduced at the L2-L3 level, which presented difficulty during withdrawal. Lumbar CT images were taken to evaluate the knot position and discuss posible solutions. The catheter was successfully removed without breakage, showing a simple knot 7 mm from its end. No neurological complications were observed. This case report demonstrates that knot formation in a lumbar epidural catheter is possible. Anesthesiology professionals should consider this complication when experiencing resistance during catheter withdrawal or injection.
Keywords: Regional anesthesia, neuraxial anesthesia, epidural analgesia, device removal, catheter, postoperative analgesia