Regional-Anaesthesie
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We report a patient who was given continuous epidural anesthesia due to painful contractions during delivery of a child after intrauterine fetal death. Placement of the catheter and repeated reinjections were carried out without problems, however, during withdrawal of the catheter it could only be pulled 1-2 cm until there was enormous resistance. ⋯ Insertion of the catheter too far into the epidural space initially must be considered as a possible cause. As this complication rarely occurs, we consider this case worth reporting.
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The availability of very fine-bore, long spinal needles (28/10 Ga) has stimulated a new wave of interest in the technique of combined spinal-epidural anesthesia. The original double-puncture technique has progressed due to special combination needles to the current spinal-needle-through-epidural-needle technique. The availability of adapted Tuohy needles, special combination sets, and long spinal needles indicates a lack of standardization. ⋯ The spinal component allows a rapid onset and intense analgesia with appropriate muscle relaxation. The epidural catheter allows the administration of agents into the epidural space as well as optimization and prolongation of analgesia in the postoperative phase. Confirming the position of the epidural catheter introduced after spinal anesthesia has been established remains a matter of concern.