Removal of a trapped epidural catheter via spinal computed tomography reconstruction and optimal position simulation of the spinal model: A case report

Abstract

Continuous epidural anesthesia is a classic anesthesia method that is widely used in abdominal surgery, labor analgesia, and postoperative analgesia. A long-term analgesic effect is achieved by continuously injecting local anesthetics into the epidural space through an epidural catheter. However, the insertion of epidural catheters is associated with various complications, such as total spinal anesthesia, nerve damage, bleeding, infection, and catheter distortion with difficult catheter removal. We present the case of a parturient woman who underwent vaginal delivery under epidural analgesia. However, after delivery, the epidural catheter could not be pulled out. Spinal computed tomography and three-dimensional reconstruction revealed that the catheter was coiled but not knotted in the spinal facet joints. Using optimal position simulation, we successfully pulled out the epidural catheter. This case demonstrates that spinal computed tomography reconstruction with optimal position simulation may be the most effective noninvasive method for successfully removing a trapped epidural catheter.