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ANALGESIA

Unrecognized Contralateral Intrapleural Catheter: Bilateral Blockade May Obscure Detection of Failed Epidural Catheterization

Michael A. Cordone, MD, MPH^*, Christopher L. Wu, MD^*, Aimee L. Maceda, MD, and Jeffrey M. Richman, MD^*

From the Departments of *Anesthesiology and Critical Care Medicine and Radiology, The Johns Hopkins University, School of Medicine; Baltimore, Maryland.

Address correspondence and reprint requests to Jeffrey M. Richman, MD, Department of Anesthesiology and Critical Care, The Johns Hopkins Hospital, 600 N. Wolfe St., Carnegie 280, Baltimore, MD 21287. Address e-mail to jrichma1{at}jhmi.edu.

Abstract

Thoracic epidural analgesia has been widely used to reduce both postoperative and posttraumatic pain. We describe a case of inadvertent right-sided interpleural catheter placement and pneumothorax during attempted epidural catheter placement for left-sided rib fractures that went unrecognized because of bilateral blockade and adequate analgesia.