Decreased Tensile Strength of an Epidural Catheter During its Removal by Grasping with a Hemostat

Abstract

Our case suggests that gripping an epidural catheter with a hemostat during the removal might result in accidental breakage of the catheter. To demonstrate the effect of the use of a hemostat, tensile strengths of catheters were measured while they were being held with either a stainless steel or rubber-sleeved hemostat.

Re: “Management of the sheared epidural catheter: is surgical extraction really necessary?”

“…We agree with the avoidance of hemostats [1] in applying traction to a lodged catheter and with inspection of the catheter for defects before insertion [2]. Suturing of the epidural catheter should also be avoided [3].…”

A comparison of two epidural catheter connectors

“…15,16 The finding that the gauge of a catheter alters its strength is unsurprising given that an increased cross-sectional area reduces the weight that must be supported by each unit of cross-sectional area. Therefore the increased diameter of the Portex catheter in our study might be expected to increase the strength of the Portex connection.…”

On knots in epidural catheters: a case report and a review of the literature

“…29,30 Values ranging from 0.51 to 4.31 kg have been reported, polyurethane catheters being most durable. 29,30 Some epidural catheters can be stretched by more than 300% of their original length without breaking while the maximal extension of others is much smaller. 2,30 These mechanical properties are altered when the catheter is damaged, e.g.…”

“…by a needle bevel, a steel forceps or a surgical blade. 29,30 If excessive force has to be applied on the catheter or if excessive stretching occurs, the catheter must be visualized using plain X-ray or computed tomography (CT) scan. If the catheter is not recognized, contrast medium should be injected in the catheter if patent, or a thin guide wire passed down the catheter if occluded.…”