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Removal of Knotted Epidural Catheters
  1. D. Gozal, M.D.,
  2. Y. Gozal, M.D. and
  3. B. Beilin, M.D.
  1. Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, Jerusalem, Israel
  1. Reprint requests: Y. Gozal, M.D., Department of Anesthesiology, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road, UHS-2, Portland, OR 97201.


Background and Objectives An epidural anesthetic was planned for a 24-year-old woman for analgesia during labor and for a 28-year-old woman for an elective cesarean delivery.

Methods Two cases of inability to remove an epidural catheter due to a knot are reported. The epidural catheter was initially inserted 6 and 8 cm, respectively, into the epidural space. Attempts to remove the catheter by gentle traction remained unsuccessful.

Results In the first case, the catheter was removed successfully by using general anesthesia with succinylcholine, and in the second case the catheter was removed by pulling it out slowly.

Conclusions To prevent the knotting of an epidural catheter, it should not be inserted more than 3-4 cm into the epidural space. General anesthesia may be one of the options to remove the catheter.

  • epidural catheter
  • knotting
  • epidural anesthesia

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