Removing knotted or stuck epidural catheters: a systematic review of case reports
Background The knotting or in vivo entrapment of epidural catheters is an uncommon but challenging issue for anesthesiologists. This study aimed to identify the possible causes behind entrapped epidural catheters and the effective methods for their removal. Methods A systematic review of relevant ca...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2023-07-01
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| Series: | Anesthesia and Pain Medicine |
| Subjects: | |
| Online Access: | http://www.anesth-pain-med.org/upload/pdf/apm-23013.pdf |
| _version_ | 1797692863024201728 |
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| author | Bikash Khadka Apurb Sharma Ashim Regmi Anup Ghimire Prajjwal Raj Bhattarai |
| author_facet | Bikash Khadka Apurb Sharma Ashim Regmi Anup Ghimire Prajjwal Raj Bhattarai |
| author_sort | Bikash Khadka |
| collection | DOAJ |
| description | Background The knotting or in vivo entrapment of epidural catheters is an uncommon but challenging issue for anesthesiologists. This study aimed to identify the possible causes behind entrapped epidural catheters and the effective methods for their removal. Methods A systematic review of relevant case reports and series was conducted using the patient/population, intervention, comparison and outcome framework and keywords such as “epidural,” “catheter,” “knotting,” “stuck,” “entrapped,” and “entrapment.” The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed, and the review protocol was registered with International Prospective Register for Systematic Reviews (CRD42021291266). Results The analysis included 59 cases with a mean depth of catheter insertion from the skin of 11.825 cm and an average duration of 8.17 h for the detection of non-functioning catheters. In 27 cases (45.8%), a radiological knot was found, with an average length of 2.59 cm from the tip. The chi-squared test revealed a significant difference between the initial and final positions of catheter insertion (P = 0.049). Conclusions Deep insertion was the primary cause of epidural catheter entrapment. To remove the entrapped catheters, the lateral decubitus position should be attempted first, followed by the position used during insertion. Based on these findings, recommendations for the prevention and removal of entrapped catheters have been formulated. |
| first_indexed | 2024-03-12T02:33:44Z |
| format | Article |
| id | doaj.art-5ecf7d3465da4d7184d6fa702ad86b65 |
| institution | Directory Open Access Journal |
| issn | 1975-5171 2383-7977 |
| language | English |
| last_indexed | 2024-03-12T02:33:44Z |
| publishDate | 2023-07-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Anesthesia and Pain Medicine |
| spelling | doaj.art-5ecf7d3465da4d7184d6fa702ad86b652023-09-05T01:46:22ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772023-07-0118331532410.17085/apm.230131199Removing knotted or stuck epidural catheters: a systematic review of case reportsBikash Khadka0Apurb Sharma1Ashim Regmi2Anup Ghimire3Prajjwal Raj Bhattarai4 Department of Anesthesia and Critical Care, Nepal Mediciti, Lalitpur, Nepal Department of Anesthesia and Critical Care, Nepal Mediciti, Lalitpur, Nepal Department of Anesthesia and Critical Care, Nepal Mediciti, Lalitpur, Nepal Department of Anesthesia and Critical Care, Nepal Mediciti, Lalitpur, Nepal Department of Anesthesia and Critical Care, Nepal Mediciti, Lalitpur, NepalBackground The knotting or in vivo entrapment of epidural catheters is an uncommon but challenging issue for anesthesiologists. This study aimed to identify the possible causes behind entrapped epidural catheters and the effective methods for their removal. Methods A systematic review of relevant case reports and series was conducted using the patient/population, intervention, comparison and outcome framework and keywords such as “epidural,” “catheter,” “knotting,” “stuck,” “entrapped,” and “entrapment.” The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed, and the review protocol was registered with International Prospective Register for Systematic Reviews (CRD42021291266). Results The analysis included 59 cases with a mean depth of catheter insertion from the skin of 11.825 cm and an average duration of 8.17 h for the detection of non-functioning catheters. In 27 cases (45.8%), a radiological knot was found, with an average length of 2.59 cm from the tip. The chi-squared test revealed a significant difference between the initial and final positions of catheter insertion (P = 0.049). Conclusions Deep insertion was the primary cause of epidural catheter entrapment. To remove the entrapped catheters, the lateral decubitus position should be attempted first, followed by the position used during insertion. Based on these findings, recommendations for the prevention and removal of entrapped catheters have been formulated.http://www.anesth-pain-med.org/upload/pdf/apm-23013.pdfcatheterdevice removalepidural anesthesiapain managementpatient positioning |
| spellingShingle | Bikash Khadka Apurb Sharma Ashim Regmi Anup Ghimire Prajjwal Raj Bhattarai Removing knotted or stuck epidural catheters: a systematic review of case reports Anesthesia and Pain Medicine catheter device removal epidural anesthesia pain management patient positioning |
| title | Removing knotted or stuck epidural catheters: a systematic review of case reports |
| title_full | Removing knotted or stuck epidural catheters: a systematic review of case reports |
| title_fullStr | Removing knotted or stuck epidural catheters: a systematic review of case reports |
| title_full_unstemmed | Removing knotted or stuck epidural catheters: a systematic review of case reports |
| title_short | Removing knotted or stuck epidural catheters: a systematic review of case reports |
| title_sort | removing knotted or stuck epidural catheters a systematic review of case reports |
| topic | catheter device removal epidural anesthesia pain management patient positioning |
| url | http://www.anesth-pain-med.org/upload/pdf/apm-23013.pdf |
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