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LETTER TO EDITOR
Year : 2010  |  Volume : 54  |  Issue : 6  |  Page : 586 Table of Contents     

A novel way of managing shearing of epidural catheter during tunnelling


Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Date of Web Publication22-Nov-2010

Correspondence Address:
Kamal Kishore
Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.72663

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How to cite this article:
Kishore K, Sahu S, Singh MK, Agarwal A, Singh P K. A novel way of managing shearing of epidural catheter during tunnelling. Indian J Anaesth 2010;54:586

How to cite this URL:
Kishore K, Sahu S, Singh MK, Agarwal A, Singh P K. A novel way of managing shearing of epidural catheter during tunnelling. Indian J Anaesth [serial online] 2010 [cited 2020 Oct 25];54:586. Available from: https://www.ijaweb.org/text.asp?2010/54/6/586/72663

Sir

Subcutaneous tunnelling of the epidural catheter is routinely practiced for anchoring the epidural catheter. There are different techniques for subcutaneous tunnelling which are associated with complications like needle stick to the clinician or shearing of the epidural catheter. Rose GL (2009) reported the efficacy of needle sheath for prevention of these complications. [1]

Still, the likelihood of shearing of the epidural catheter cannot be ruled out. Following shearing of the epidural catheter it has to be pulled out, as it cannot be used for administering medication. [2] Recently, we came across shearing of epidural catheter during subcutaneous tunnelling [Figure 1]. We did not pull out the epidural catheter; rather we cut the catheter at the point of shearing and attached the cut end of the catheter (near the point of exit from the back of the patient) to the catheter connector and filter assembly. Thereafter we administered medication through this assembly that was later fixed to the back of the patient [Figure 2]. Subsequently a high-pressure, low-volume extension tube was attached to the assembly, which was used for administration of drugs for the management of postoperative pain. We could safely and effectively manage the patient intra-operatively and took care of his postoperative pain (three days) without the need of replacing the epidural catheter thereby saving time and money.
Figure 1: Shearing of epidural catheter during subcutaneous tunnelling

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Figure 2: Cut end of the catheter at the point of shearing, which was attached to the catheter connector and filter assembly

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Fortunately, shearing of the catheter happened at an extracutaneous site so we got extra length to attach the filter and other assembly with it. Although, short length of catheter or slightly bulky assembly (filter system) or absence of loop may pose a possibility of dislodgement it is a safe and cost-effective method. We therefore suggest that this technique could be employed in cases of shearing of epidural catheter during the process of subcutaneous tunnelling.

 
   References Top

1.Rose GL. Subcutaneous catheter tunnelling. Reg Anesth PainMed 2009;34:379.  Back to cited text no. 1
    
2.Mitra R, Fleischmann K. Management of the sheared epidural catheter: is surgical extraction really necessary? J Clin Anesth 2007;19:310-4.  Back to cited text no. 2
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    Figures

  [Figure 1], [Figure 2]



 

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