Abstract

Epidural catheters that are commonly placed for anaesthesia or analgesia have a serious complication of migration. Besides intravascular local anaesthetic infusion which could lead to systemic toxicity, a subdural migration is often diagnosed late and presents with life-threatening outcomes noted either at post-mortem or requiring intensive care management. Albeit training and protocols for insertion, administering and management of epidurals have been established, not all complications can be mitigated. We present a case of an epidural catheter migration in a patient with timely detection and management without airway compromise with an analysis of the detection, diagnosis and management. Various methods for diagnosis have been described in the literature as we discuss the pros and cons of bedside and radiological investigations. A high index of suspicion and knowledge of potential problems in the management of patient with in-dwelling epidural catheters prove vital to avoid complications with catheter migration. Adequate training and availability of emergency contact details would expedite management in emergencies.

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