Accidental catheterization of epidural venous plexus: tomographic analysis
Background and objectives: Inadvertent venous catheterizations occur in approximately 9% of lumbar epidural anesthetic procedures with catheter placement and, if not promptly recognized, can result in fatal consequences. The objective of this report is to describe a case of accidental catheterizatio...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2016-03-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001414000281 |
| _version_ | 1811236618783162368 |
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| author | Mariano Paiva Souza Edno Magalhães Elialba de Farias Cascudo Marco Antonio Dias Jogaib Marcelo Carneiro da Silva |
| author_facet | Mariano Paiva Souza Edno Magalhães Elialba de Farias Cascudo Marco Antonio Dias Jogaib Marcelo Carneiro da Silva |
| author_sort | Mariano Paiva Souza |
| collection | DOAJ |
| description | Background and objectives: Inadvertent venous catheterizations occur in approximately 9% of lumbar epidural anesthetic procedures with catheter placement and, if not promptly recognized, can result in fatal consequences. The objective of this report is to describe a case of accidental catheterization of epidural venous plexus and its recording by computed tomography with contrast injection through the catheter. Case report: A female patient in her sixties, physical status II (ASA), underwent conventional cholecystectomy under balanced general anesthesia and an epidural with catheter for postoperative analgesia. During surgery, there was clinical suspicion of accidental catheterization of epidural venous plexus because of blood backflow through the catheter, confirmed by the administration of a test dose through the catheter. After the surgery, a CT scan was obtained after contrast injection through the catheter. Contrast was observed all the way from the skin to the azygos vein, passing through anterior and posterior epidural venous plexuses and intervertebral vein. Conclusion: It is possible to identify the actual placement of the epidural catheter, as well as to register an accidental catheterization of the epidural venous plexus, using computed tomography with contrast injection through the epidural catheter. Resumo: Justificativa e objetivos: A cateterização venosa inadvertida ocorre em aproximadamente 9% das anestesias peridurais lombares com introdução de cateter e caso não seja prontamente reconhecida pode trazer consequências fatais. O objetivo deste relato é descrever um caso de cateterização acidental do plexo venoso peridural e o seu registro por tomografia computadorizada com injeção de contraste pelo cateter. Relato de caso: Paciente feminina, sexagenária, estado físico II (ASA), submetida à colecistectomia convencional sob anestesia geral balanceada e peridural com cateter para analgesia pós-operatória. Durante cirurgia houve suspeição clínica de cateterização acidental do plexo venoso peridural, por refluxo de sangue pelo cateter, fato confirmado pela administração de dose-teste pelo cateter. Feita tomografia computadorizada com injeção de contraste pelo cateter, após o termino da cirurgia. Observado todo o trajeto do contraste desde a pele até a veia ázigo, passando pelo plexo venoso peridural anterior, posterior e veia intervertebral. Conclusão: É possível a identificação do real posicionamento do cateter peridural, bem como o registro da cateterização acidental do plexo venoso peridural, por meio de tomografia computadorizada com injeção de contraste pelo cateter peridural. Keywords: Complications: venous catheterization, Anesthesia: epidural anesthesia, Epidural catheter, Tomography: venous plexus, Intervertebral vein, Azygos vein, Palavras-chave: Complicações: cateterização venosa, Anestesia: peridural, Cateter peridural, Tomografia: plexo venoso, Veia intervertebral, Veia ázigo |
| first_indexed | 2024-04-12T12:12:12Z |
| format | Article |
| id | doaj.art-313898ea8383488b92cd26dceb4c8291 |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-12T12:12:12Z |
| publishDate | 2016-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-313898ea8383488b92cd26dceb4c82912022-12-22T03:33:33ZengElsevierBrazilian Journal of Anesthesiology0104-00142016-03-01662208211Accidental catheterization of epidural venous plexus: tomographic analysisMariano Paiva Souza0Edno Magalhães1Elialba de Farias Cascudo2Marco Antonio Dias Jogaib3Marcelo Carneiro da Silva4Hospital Regional do Gama (HRG), Brasília, DF, Brazil; Corresponding author.Universidade de Brasília (UnB), Brasília, DF, Brazil; Scientific Department, Sociedade Brasileira de Anestesiologia, Brasília, DF, BrazilHospital Regional do Gama (HRG), Brasília, DF, BrazilHospital Regional do Gama (HRG), Brasília, DF, BrazilHospital Regional do Gama (HRG), Brasília, DF, BrazilBackground and objectives: Inadvertent venous catheterizations occur in approximately 9% of lumbar epidural anesthetic procedures with catheter placement and, if not promptly recognized, can result in fatal consequences. The objective of this report is to describe a case of accidental catheterization of epidural venous plexus and its recording by computed tomography with contrast injection through the catheter. Case report: A female patient in her sixties, physical status II (ASA), underwent conventional cholecystectomy under balanced general anesthesia and an epidural with catheter for postoperative analgesia. During surgery, there was clinical suspicion of accidental catheterization of epidural venous plexus because of blood backflow through the catheter, confirmed by the administration of a test dose through the catheter. After the surgery, a CT scan was obtained after contrast injection through the catheter. Contrast was observed all the way from the skin to the azygos vein, passing through anterior and posterior epidural venous plexuses and intervertebral vein. Conclusion: It is possible to identify the actual placement of the epidural catheter, as well as to register an accidental catheterization of the epidural venous plexus, using computed tomography with contrast injection through the epidural catheter. Resumo: Justificativa e objetivos: A cateterização venosa inadvertida ocorre em aproximadamente 9% das anestesias peridurais lombares com introdução de cateter e caso não seja prontamente reconhecida pode trazer consequências fatais. O objetivo deste relato é descrever um caso de cateterização acidental do plexo venoso peridural e o seu registro por tomografia computadorizada com injeção de contraste pelo cateter. Relato de caso: Paciente feminina, sexagenária, estado físico II (ASA), submetida à colecistectomia convencional sob anestesia geral balanceada e peridural com cateter para analgesia pós-operatória. Durante cirurgia houve suspeição clínica de cateterização acidental do plexo venoso peridural, por refluxo de sangue pelo cateter, fato confirmado pela administração de dose-teste pelo cateter. Feita tomografia computadorizada com injeção de contraste pelo cateter, após o termino da cirurgia. Observado todo o trajeto do contraste desde a pele até a veia ázigo, passando pelo plexo venoso peridural anterior, posterior e veia intervertebral. Conclusão: É possível a identificação do real posicionamento do cateter peridural, bem como o registro da cateterização acidental do plexo venoso peridural, por meio de tomografia computadorizada com injeção de contraste pelo cateter peridural. Keywords: Complications: venous catheterization, Anesthesia: epidural anesthesia, Epidural catheter, Tomography: venous plexus, Intervertebral vein, Azygos vein, Palavras-chave: Complicações: cateterização venosa, Anestesia: peridural, Cateter peridural, Tomografia: plexo venoso, Veia intervertebral, Veia ázigohttp://www.sciencedirect.com/science/article/pii/S0104001414000281 |
| spellingShingle | Mariano Paiva Souza Edno Magalhães Elialba de Farias Cascudo Marco Antonio Dias Jogaib Marcelo Carneiro da Silva Accidental catheterization of epidural venous plexus: tomographic analysis Brazilian Journal of Anesthesiology |
| title | Accidental catheterization of epidural venous plexus: tomographic analysis |
| title_full | Accidental catheterization of epidural venous plexus: tomographic analysis |
| title_fullStr | Accidental catheterization of epidural venous plexus: tomographic analysis |
| title_full_unstemmed | Accidental catheterization of epidural venous plexus: tomographic analysis |
| title_short | Accidental catheterization of epidural venous plexus: tomographic analysis |
| title_sort | accidental catheterization of epidural venous plexus tomographic analysis |
| url | http://www.sciencedirect.com/science/article/pii/S0104001414000281 |
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