Retained epidural catheter: an update

Abstract

The retained catheter fragment is a rare complication when performing epidural techniques. There is a paucity of studies available, with Australian data quoting an incidence of 1 in 60,000. For this article, we reviewed 36 case reports of retained epidural catheters between 1995 and 2020. The case reports found computed tomography scans to be the most reliable modality to investigate a retained epidural catheter. The decision to surgically remove or treat conservatively should be multidisciplinary with most operations involving symptomatic or long fragments. In our review, we found 25 (69.4%) reports of surgical removal, with 21 opting for immediate removal. Conservatively treated retained fragments should be monitored for neurological or infective complications. Patients should receive a follow-up plan and be educated regarding red flag symptoms to facilitate further management. For future reference, a detailed documentation of the incident, parties involved, discussions, and decisions should be made.