P093 Epidural catheter breakage after normal vaginal delivery

<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted</b>: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission <h3>Application for ESRA Abstract Prizes</h3> : I apply as an Anesthesiologist (Aged 35 years old or less) <h3>Background and Aims</h3> Breakage of epidural catheters is an unusual occurrence whose subsequent therapy lacks uniformity due to the absence of a consensus and defined standards. We present a rare complication of epidural catheter breakage with some resistance appeared during removal, without any neurological sequalae in 20 year old primigravida lady after normal vaginal delivery. <h3>Methods</h3> Immediately we send the patient to radiology department for lumbar x ray that could not show the missing catheter, so CT lumbar showing: The epidural catheter segment is seen passing through L1/2 interspinous level , its proximal segment coursing vertically upwards along the epidural space for 1.6 cm. Its distal end noted left off midline just deep to the prevertebral fascia, lying about 2 cm deep to the skin surface. Evidence of multiple air foci epidural and along the subcutaneous tissue of the back (recent post-epidural anesthesia). Neurosurgery consultation with successful removal of the breakage part under GA. The patient discharged home without any neurological deficit. <h3>Results</h3> The management of epidural catheter breakage depends on: If the fragment is in the spinal canal: Surgical removal is often recommended, especially if the patient is experiencing symptoms like neurological deficits. If the fragment is outside the spinal canal: Conservative management: If the patient is asymptomatic and the fragment is not causing any issues. Surgical removal: This may be considered if there is a risk of infection or neurological complications, or if the patient is concerned about the retained fragment. <h3>Conclusions</h3> Management of a broken epidural catheter fragment depends on its location and the patient‘s symptoms. In our case the epidural catheter should be removed as the patient is concerned about this missing part as well as our protocol it is considered as foreign body with possible delayed complications that could affect patient‘s health.