title: Intrapleural placement of a thoracic epidural catheter in a patient with spinal stenosis.
abstract: Due to the close proximity of the thoracic epidural space and parietal pleura, pleural puncture with intrapleural catheter placement is a potential complication of thoracic epidural anesthesia. The authors present a case of an obese patient with a history of spinal stenosis that underwent thoracotomy. Repeated failed attempts at epidural anesthesia were complicated by intrapleural placement of the catheter. The patient subsequently developed clinical signs of pneumothorax and required urgent thoracostomy.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Kiran
authors.initials: K
authors.lastname: Belani
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. Electronic address: mmonteal@bidmc.harvard.edu.
authors.forename: Mario
authors.initials: M
authors.lastname: Montealegre-Gallegos
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Ferla
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Robina
authors.initials: R
authors.lastname: Matyal
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D009407:Nerve Block / Q000379:methods; D009765:Obesity / Q000150:complications*; D010994:Pleura; D011013:Pneumonectomy / Q000009:adverse effects; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology; D011859:Radiography; D013130:Spinal Stenosis / Q000150:complications*; D013908:Thoracotomy / Q000009:adverse effects
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local
keywords: Epidural anesthesia; Peroperative complications; Regional anesthesia