Korean J Anesthesiol.  2009 Dec;57(6):796-799. 10.4097/kjae.2009.57.6.796.

Occluded Espocan(R) needle and accidental dural puncture during combined spinal-epidural anesthesia: A case report

• Kim BS
• Lee JH
• Min BW
• Ban JS
• Lee SK
• Kim EJ

• KMID: 2239806
• DOI: http://doi.org/10.4097/kjae.2009.57.6.796

Abstract

Here, we report a case of an occluded modified Tuohy needle (Espocan(R), B. Brown, Germany) due to the patient's own tissue. A 70-year-old female with left knee osteoarthritis was admitted for a total knee replacement arthroplasty under combined spinal-epidural anesthesia. Insertion of the Tuohy needle proceeded from the skin to 6 cm and then 6.5 cm, but there was no loss of resistance. We removed the needle from the patient and discovered a fibrous, white tissue inside the needle. We tried again and did the spinal-epidural anesthesia in another interspinous space. This time, we could feel the loss of resistance at 4 cm, but permanent leakage of clear fluid was seen in the epidural catheter so we removed the catheter. We observed the patient closely in the recovery room and ward, and no further complications were found. We present this case to remind the operator the importance of checking the epidural needle that possible may be occluded by a foreign body.

Keyword

Combined spinal-epidural anesthesia; Foreign body; Tuohy needle

MeSH Terms

Aged
Anesthesia
Arthroplasty
Arthroplasty, Replacement, Knee
Catheters
Female
Foreign Bodies
Humans
Needles
Osteoarthritis, Knee
Punctures
Recovery Room
Skin