Epidural or subarachnoid catheters (sometimes called lumbar drainage catheters) are very small hollow tubes inserted into the epidural or subarachnoid space to administer medications or drain body fluids, respectively. Under certain conditions they can shear, leaving a fragment in the patient. Between June 2004 and December 2008, the Pennsylvania Patient Safety Authority received 13 reports related to epidural or subarachnoid catheter shear. However, most catheter procedures occur without complications. The predominant causes of catheter shear are applying excessive force while removing the catheter, withdrawing the catheter back through the needle, withdrawing the catheter over a deformed or damaged needle bevel, or damaging the catheter during or after placement in the patient. Defects in the catheter occuring [sic] during the manufacturing process can also be a cause of catheter shear. The position of the patient during insertion and withdrawal of the catheter can play an important part in reducing the likelihood of fracturing the catheter. For difficult-to-remove catheters, allowing the patient's back muscles to relax for a few days may facilitate the removal in some cases. Unless complications arise, surgery is unnecessary in most cases since catheters are constructed from inert materials.
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