This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tsui, B. C. H. Articles by Kulkarni, P. Search for Related Content PubMed PubMed Citation Articles by Tsui, B. C. H. Articles by Kulkarni, P. Related Collections Complications Regional Anesthesia

---

ANALGESIA

Migration of a Thoracic Epidural Catheter into the Intercostal Space via the Intervertebral Foramen

From the Department of Anesthesiology and Pain Medicine, University of Alberta and affiliated Stollery Children's Hospital, Edmonton, Alberta, Canada.

Address correspondence and reprint requests to Ban C.H. Tsui, MSC, MD, FRCP(C), Department of Anesthesiology and Pain Medicine, 8–120 Clinical Sciences Building, Edmonton, Alberta, Canada T6G 2G3. Address e-mail to btsui{at}ualberta.ca or www.edmara.ca.

Abstract

We describe a documented migration of a thoracic epidural catheter into the thoracic cage in a 5-wk-old with DiGeorge's syndrome and an uncorrected acyanotic Tetralogy of Fallot who underwent laparotomy for malrotation, gastric fundoplication, and gastrostomy tube insertion under combined general and epidural anesthesia. A 20-gauge stimulating catheter was inserted caudally and advanced cephalad to the thoracic level while applying a low electrical current (1–10 mA) to confirm epidural placement at approximately T5–6. Despite good pain control through the third postoperative day, using an epidural infusion of bupivacaine 0.1% at 1–1.2 mL/h, radiography demonstrated catheter migration into the seventh intercostal space.