Case Report

Knotting of a Lumbar Epidural Catheter during its Removal: A Case Report


Knotting of an epidural catheter is a rare complication during the removal of an epidural catheter. There are many factors for knotting of an epidural catheter, such as the characteristics of the catheter itself, patient's factors [anatomy, position during insertion and removal of the catheter, and the body mass index (BMI)], the difficulty of the procedure and the distance of advancing the catheter in epidural space. During its removal, we experienced a knot of a lumbar epidural catheter which was inserted for labor pain analgesia. The knot was successfully removed. In this case, the knotting was due to long distance advancement of the catheter, which was double knotted and looped in epidural space, far from its distal tip. To prevent this complication, catheters should be left with less than 6 cm in length in the epidural space.

Kim JI, Kim DK, Lee JW, Son JS. The Breakage of epidural catheter during continuous epidural analgesia for cancer pain-a case report. Korean J Anesthesiol 2007; 53(4): 513-5.

Hobaika AB. Breakage of epidural catheters: Etiology, prevention, and management. Rev Bras Anestesiol 2008; 58(3): 227-33.

Huang J, Lawrence J, Sposato M. Another case of knotting of an epidural catheter. AANA J 2010; 78(2): 93-4.

Ravishankar CK. Knotted epidural catheter in an infant: A case report. Indian J Anaesth 2017; 61(5): 444-6.

Muneyuki M, Shirai K, Inamoto A. Roentgenographic analysis of the positions of catheters in the epidural space. Anesthesiology 1970; 33(1): 19-24.

Sood J, Jain P, Kanthed P. Epidural catheter breakage: A dilemma. Indian J Anaesth 2007; 51(5): 434-7.

Karraz MA. Knotting of an epidural catheter like a tie. Anesth Analg 2002; 95(1): 257.

Rosenberg PH. Complications of catheter techniques. In: Finucane BT, Editor. Complications of regional anesthesia. Berlin, Germany: Springer Science & Business Media; 2007. p. 263-81.

Browne RA, Politi VL. Knotting of an epidural catheter: A case report. Can Anaesth Soc J 1979; 26(2): 142-4.

Lee YH, Hwang HY, Sim WS, Yang M, Lee CJ. Breakage of a thoracic epidural catheter during its removal-A case report. Korean J Anesthesiol 2010; 58(6): 569-72.

IssueVol 2 No 3 (2017): Summer QRcode
SectionCase Report(s)
Catheter Complications Epidural analgesia Labor pain

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Natajmajd M, Hosseini L. Knotting of a Lumbar Epidural Catheter during its Removal: A Case Report. CRCP. 2018;2(3):75-78.