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KMID : 0356920070530040544
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Korean Journal of Anesthesiology
2007 Volume.53 No. 4 p.544 ~ p.546
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Intravascular Migration of an Epidural Catheter Despite using Several Testing Maneuvers
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Kim Young-Taek
Kim Shin-Sung
Ryu Ji-Keun
Jung Wook
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Abstract
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Epidural anesthesia for cesarean section allows the mother to be awake, minimizes or completely avoids the problem of maternal aspiration and neonatal drug depression from general anesthetics. But epidural anesthesia has the potential to produce local anesthetic systemic toxicity or inadvertent high spinal block which is due to unintentional administration of drug into an epidural vessel or subarachnoid space. There are several ways to avoid these complications. These include careful aspiration of epidural catheter, fractionation of the epidural dose, and the use of epinephrine containing epidural test dose before injection of epidural dose. We report a case of a pregnant woman who had developed a seizure after an injection of the epidural anesthetic. This occurred despite using the techniques of aspiration and epinephrine containing epidural test dose injection. So we thought that the seizure occurred probably by the migration of epidural catheter while changing positions and it should be considered in all cases of epidural anesthesia.
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KEYWORD
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cesarean section, epidural anesthesia, epinephrine, changing positions, seizure, test dose
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