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Epidural Catheter Knotting in an Elderly Patient-A Case Report

 陳茂凱(Mao-Kai Chen);吳昇樺(Sheng-Hua Wu);施智凱(Chih-Kai Shih);陳美錦(Mei-Chin Chen);陳玫君(Mei-Chun Chen);周笑華(Siu-Wah Chau)
Epidural anesthesia is a widely used technique in current anesthesia practice. It offers a valuable additional function, postoperative pain control. Some rare complications such as entrapment and knotting might happen during remove of the epidural catheter. It is a great challenge to anesthesiologists and may need surgical intervention. Knotted and entrapped catheters were mostly described in obstetrics. We reported a nonobstetric elderly patient with difficulty in removing a 20-guage soft epidural catheter (Perifix(superscript ?, Soft 501 filter set, B.BRAUN). In this case, the catheter was successful removed with steady gentle traction by changing patient's position. The conclusion was that the catheter length left in epidural space should be less than 5 cm, and the possibility of epidural knotting was higher when soft catheter was used in old age patient.