Epidural catheter

Many complications of epidural catheter placement have been described. I recently experienced an unusual difficulty that has not been described to date. A standard lumbar epidural was performed for obstetric analgesia using a Portex epidural pack. Identification of the epidural space was straightforward and catheter placement was easy. Upon trying to slide the Tuohy needle off the catheter, a severe resistance was experienced and the only way of removing the needle was to cut the catheter at the distal end of the needle with a sterile blade. The epidural filter was then attached to this cut end and the epidural analgesia was successfully initiated. The needle and remains of the ‘jammed’ catheter were sent to Portex for further examination. Portex cut through the plastic hub of the needle to demonstrate the obstructed catheter (see Fig. 10). I, like many other anaesthetists, do not use the feeding guide supplied by␣the manufacturers with this pack. Portex have suggested that the coiled nature of the epidural catheter can lead to coiling within the hub of the needle if the feeding guide is not used. I have changed my practice as a result of this experience and suggest that others consider doing the same.