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Anesthesia and analgesia · Jan 2009
Case ReportsMigration of a thoracic epidural catheter into the intercostal space via the intervertebral foramen.
- Ban C H Tsui and Pradeep Kulkarni.
- Department of Anesthesiology and Pain Medicine, Edmonton, Alberta, Canada. btsui@ualberta.c
- Anesth. Analg. 2009 Jan 1;108(1):371-3.
AbstractWe describe a documented migration of a thoracic epidural catheter into the thoracic cage in a 5-wk-old with DiGeorge's syndrome and an uncorrected acyanotic Tetralogy of Fallot who underwent laparotomy for malrotation, gastric fundoplication, and gastrostomy tube insertion under combined general and epidural anesthesia. A 20-gauge stimulating catheter was inserted caudally and advanced cephalad to the thoracic level while applying a low electrical current (1-10 mA) to confirm epidural placement at approximately T5-6. Despite good pain control through the third postoperative day, using an epidural infusion of bupivacaine 0.1% at 1-1.2 mL/h, radiography demonstrated catheter migration into the seventh intercostal space.
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