When The Unexpected Happens: The Intriguing Retrieval of a Broken Epidural Catheter.

Abstract

The accidental breakage of an epidural catheter during placement or removal poses a rare but challenging situation in clinical practice. This case report presents the successful removal of a broken epidural catheter and highlights the management strategies employed. A 41-year-old male patient underwent a planned orthopedic implant removal surgery under epidural anesthesia. During catheter removal, a portion of the catheter fractured and remained lodged within the epidural space. The patient experienced persistent pain and concern regarding the retained fragment, necessitating immediate intervention. A multidisciplinary team comprising an orthopedic surgeon, neurosurgeon, anesthesiologist, and radiologists collaborated to develop a tailored retrieval strategy. Magnetic resonance imaging aided in localizing the fractured catheter fragment. Using a standard midline posterior approach, the catheter was safely removed without any complications. Post-retrieval monitoring revealed no adverse events, and the patient reported resolution of pain and improved satisfaction. Retrieving a broken epidural catheter requires a systematic and individualized approach. This case report contributes to the existing literature by providing insights into managing this rare complication, highlighting the importance of a multidisciplinary team, appropriate imaging, and meticulous retrieval techniques to ensure patient safety and optimal outcomes.