Abstract

GUILHERME, Sudbrack  and  GEIER, Karl Otto. Displaced epidural catheter: a reason for analgesia failure. Case report. Rev. Bras. Anestesiol. [online]. 2002, vol.52, n.1, pp. 55-61. ISSN 0034-7094.  http://dx.doi.org/10.1590/S0034-70942002000100007.

BACKGROUND AND OBJECTIVES: Epidural catheter migration is a rare event. However, when post local anesthetic injection conductive blockade is not obtained it is to be suspected that the catheter is not in the desirable site. This report aimed at describing a case of epidural catheter migration (L₃-L₄) to the right greater psoas muscle, which was radiologically confirmed. CASE REPORT: Female patient, 58 years of age, with obliterating thromboangiitis, submitted to left hallux amputation under combined spinal-epidural anesthesia. Spinal puncture was performed at L₄-L₅ and the epidural catheter was inserted at L₃-L₄ aiming at postoperative patient-controlled epidural analgesia (PCA). Since there were no postoperative PCA results, there was a suspicion of epidural catheter migration, which was radiologically confirmed. The catheter crossed the intervertebral foramen and was lodged in the right greater psoas muscle. CONCLUSIONS: The absence of effects after repeated analgesic injections through the epidural catheter led to the suspicion that it was not properly placed. A radiological exam with contrast confirmed the diagnosis.

Keywords : ANALGESIA, Postoperative [patient-controlled analgesia]; COMPLICATIONS [failure].