[Failures of lumbar epidural analgesia caused by transforaminal passage of an epidural catheter in two cases].
In 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.
Saitoh
K
K
Department of Anesthesiology, Jichi Medical School, Tochigi.
Kawakami
N
N
Hotta
K
K
Hirabayashi
Y
Y
Mitsuhata
H
H
Shimizu
R
R
D000328:Adult; D015360:Analgesia, Epidural; D002404:Catheterization / Q000009:adverse effects*; D004824:Epidural Space / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008619:Mepivacaine / Q000506:poisoning; D011859:Radiography
D008619:Mepivacaine