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Case Reports
[Failures of lumbar epidural analgesia caused by transforaminal passage of an epidural catheter in two cases].
- K Saitoh, N Kawakami, K Hotta, Y Hirabayashi, H Mitsuhata, and R Shimizu.
- Department of Anesthesiology, Jichi Medical School, Tochigi.
- Masui. 1994 Jul 1;43(7):1041-3.
AbstractIn one case, analgesia level obtained with a 20 ml of 1.5% mepivacaine was unilateral and inadequate. In the other case, an epidural catheter was inserted after a 20 ml of 2% mepivacaine was injected through a Tuohy needle. Toxicity by local anesthetic was induced by an overdose of local anesthetic through the catheter. In both cases, transforaminal passage of a catheter was confirmed by epidurogram with iohexol. If an epidural catheter is advanced beyond 5 cm into the epidural space, it may migrate outwards through the intervertebral foramen. Therefore, the insertion of an epidural catheter should be limited to 3-4 cm.
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