Migrating thoracic epidural catheter in an infant.
Infants have a shorter neuraxial length and shorter skin to epidural space than adults. Even small amounts of migration may produce significant and unintended effects. Optimal fixation to prevent migration, bacterial colonization, and leakage is not clear from the literature. We report the case of a thoracic epidural that migrated inward for six centimeters, associated with loss of analgesic effect.
Department of Anesthesia, Children's Hospital of Colorado and University of Colorado, Aurora, CO 80045, USA. mark.thompson@childrenscolorado.org
Mark E
ME
Thompson
Heidi
H
Aasheim
D000577:Amides / Q000008:administration & dosage / Q000627:therapeutic use; D000700:Analgesics / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D057785:Catheters / Q000009:adverse effects*; D020878:Device Removal; D004361:Drug Tolerance; D004824:Epidural Space / Q000033:anatomy & histology*; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D005548:Foreign-Body Migration; D006801:Humans; D007223:Infant; D008297:Male; D010147:Pain Measurement; D000077212:Ropivacaine
D000577:Amides; D000700:Analgesics; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine; D005283:Fentanyl