Complications of Catheter Techniques

  • Per H. Rosenberg


Catheters for prolongation of nerve blocks were first used in the 1940s, when ureteral lacquered silk catheters were applied in continuous caudal (sacral) analgesia,1,2 continuous subarachnoid block,3 and continuous lumbar epidural block.4 Thereafter, there has been a steady development in plastic material technology and polyethylene and polyvinyl catheters have been followed bypresently used nylon (polyamide), polyurethane, and Teflon (tetrafluoroethylene) catheters. Still today, there seems to be no universally ideal catheter material, and the material, design, and diameter of regional anesthesia and analgesia catheters are chosen according to the specific requirements associated with the various blocks. Overall, the catheter material is such that in a case of resistance or obstruction, the catheter must not break.5 For example, an epidural catheter should advance into and through the needle rather than flex excessively when resistance is encountered, and yet still bend and deflect off tissue.6 The deflection property has been solved in some of the epidural catheters by a “soft” and flexible steel coil extension of the tip (e.g., Arrow Flextip®). An intrathecal catheter should be soft, relatively thin, and resistant to kinking. However, a brachial plexus catheter has to be relatively stiff and blunt. In addition to acceptable tissue compatibility, the catheter must also withstand the destructive (solubilizing) action of the neurolytic drug solutions administered through the catheters, such as 6%–10% phenol or 100% ethanol.


Brachial Plexus Epidural Analgesia Epidural Catheter Epidural Abscess Brachial Plexus Block 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Manalan SA. Caudal block anesthesia in obstetrics. J Indiana Med Assoc 1942;45:564–565.Google Scholar
  2. 2.
    Adams RC, Lundy JS, Seldon TH. Continuous caudal anesthesia or analgesia: a consideration of the technic, various uses and some possible dangers. JAMA 1943;25:152–158.Google Scholar
  3. 3.
    Tuohy EB. Continuous spinal anesthesia: a new method of utilising a ureteral catheter. Surg Clin North Am 1945;25:834–840.Google Scholar
  4. 4.
    Curbelo MM. Continuous peridural segmental anesthesia by means of ureteral catheter. Anesth Analg Curr Res 1949;28:13–22.Google Scholar
  5. 5.
    Edell TA, Ramamurthy S. Catheters for neural blockade: materials and design. Tech Reg Anesth Pain Manage 1998;2:103–110.Google Scholar
  6. 6.
    Eckmann DM. Variations in epidural catheter manufacture: implications for bending and stiffness. Reg Anesth Pain Med 2003;28:37–42.PubMedGoogle Scholar
  7. 7.
    Niemi L, Pitkänen M, Tuominen M, Rosenberg PH. Technical problems and side effects associated with continuous intrathecal or epidural postoperativeanalgesia inpatients undergoing hip arthroplasty. Eur J Anaesthesiol 1994;11:469–474.PubMedGoogle Scholar
  8. 8.
    Bahar M, Chanimov M, Cohen ML, et al. The lateral recumbent head-down position decreases the incidence of epidural veinous puncture during catheter insertion in obese patients. Can J Anaesth 2004;51:577–580.PubMedGoogle Scholar
  9. 9.
    Harney D, Moran CA, Whitty R, Harte S, Geary M, Gardiner J. Influence of posture on the incidence of vein cannulation during epidural catheter placement. Eur J Anaesthesiol 2005;22:103–106.PubMedGoogle Scholar
  10. 10.
    Ryan DW. Accidental intravenous injection of bupivacaine: a complication of obstetric epidural anaesthesia. Br J Anaesth 1973;45:907–908.PubMedGoogle Scholar
  11. 11.
    Hylton RR, Eger EI II, Rovno SH. Intravascular placement of epidural catheters. Anesth Analg Curr Res 1964;43:379–382.Google Scholar
  12. 12.
    Usubiaga JE. Neurological complications following epidural anesthesia. Int Anesthesiol Clin 1975;13:1–153.PubMedGoogle Scholar
  13. 13.
    McNeill MJ, Thorburn J. Cannulation of the epidural space. A comparison of 18-and 16-gauge needles. Anaesthesia 1988;43:154–155.PubMedGoogle Scholar
  14. 14.
    Mannion D, Walker R, Clayton K. Extradural vein puncture —an avoidable complication. Anaesthesia 1991;46:585–587.PubMedGoogle Scholar
  15. 15.
    Banwell BR, Morley-Forster P, Krause R. Decrease incidence of complications with the Arrow (FlexTip Plus) epidural catheter. Can J Anaesth 1998;45:370–372.PubMedGoogle Scholar
  16. 16.
    Hartley M. A strange case of inadvertent spinal. Br J Anaesth 1975;47:420.PubMedGoogle Scholar
  17. 17.
    Ward CF, Osborne R, Benumof JL, Saidman LJ. A hazard of double-orifice epidural catheters. Anesthesiology 1978;48:362–364.PubMedGoogle Scholar
  18. 18.
    Beck H, Brassow F, Doehn M, Bause H, Dziadzka A, Schulte am Esch J. Epidural catheters of multi-orifice type: dangers and complications. Acta Anaesthesiol Scand 1986;30:549–555.PubMedGoogle Scholar
  19. 19.
    Morrison LM, Buchan AS. Comparison of complications associated with single-holed and multi-holed extradural catheters. Br J Anaesth 1990;64:183–185.PubMedGoogle Scholar
  20. 20.
    Woehlck HJ, Bolla B. Uncoiling of wire in Arrow Flextip epidural catheter on removal. Anesthesiology 2000;92:907–909.PubMedGoogle Scholar
  21. 21.
    Bastien JL, McCarroll MG. Uncoiling of Arrow Flextip Plus epidural catheter reinforcing wire during catheter removal: anunusual complication. Anesth Analg 2004;98:554–555.PubMedGoogle Scholar
  22. 22.
    Tsui BC, Gupta S, Finucane B. Confirmation of epidural catheter placement using nerve stimulation. Can J Anaesth 1998;45:640–644.PubMedGoogle Scholar
  23. 23.
    Tsui BC, Gupta S, Finucane B. Detection of subarachnoid and intravascular epidural catheter placement. Can J Anaesth 1999;46:675–678.PubMedGoogle Scholar
  24. 24.
    De Vore JS, Asrani R. Bupivacaine-induced seizure inobstetrics. Anesthesiology 1978; 48:386–387.Google Scholar
  25. 25.
    Ravindran R, Albrecht W, McKay M. Apparent intravascularmigration of an epidural catheter. Anesth Analg 1979;58:252–253.PubMedGoogle Scholar
  26. 26.
    Zebrowski ME, Gutsche BB. More on intravascular migration of an epidural catheter. Anesth Analg 1979;58:531.PubMedGoogle Scholar
  27. 27.
    Dickson MA, Doyle E. The intravascular migration of an epiduralcatheter. Paediatr Anaesth 1999;9:273–275.PubMedGoogle Scholar
  28. 28.
    Robson JA, Brodsky JB. Latent dural puncture after lumbar epidural block. Anesth Analg 1977;56:725–726.PubMedGoogle Scholar
  29. 29.
    Skowronski G A, Rigg J RA. Total spinal block complicating epidural analgesia in labour. Anaesth Intensive Care 1981;9:274–276.PubMedGoogle Scholar
  30. 30.
    Sasakawa T, Nagashima M, Hamada I, et al. Delayed subarachnoid migration of an epidural catheter: a case report [Japanese]. Masui 2004;53:284–286.PubMedGoogle Scholar
  31. 31.
    Chadwick VL, Jones M, Poulton B, Fleming BG. Epidural catheter migration: a comparison of tunnelling against a new technique of catheter fixation. Anaesth Intensive Care 2003;31:518–522.PubMedGoogle Scholar
  32. 32.
    Blomberg RA, Löfström JB. The test dose in regional anaesthesia. Acta Anaesthesiol Scand 1991;35:465–468.PubMedGoogle Scholar
  33. 33.
    Gaiser RR. The epidural test dose in obstetric anesthesia: it is not obsolete. J Clin Anesth 2003;15:474–477.PubMedGoogle Scholar
  34. 34.
    Norris MC, Ferrenbach D, Dalman H, et al. Does epinephrine improve the diagnostic accuracy of aspiration during labor epidural analgesia? Anesth Analg 1999;88:1073–1076.PubMedGoogle Scholar
  35. 35.
    Gieraerts R, Van Zundert A, De Wolf A, Vaes L. Ten ml bupivacaine 0.125% with 12.5 micrograms epinephrine is a reliable epidural test dose to detect inadvertent intravascular injection in obstetric patients. A double-blind study. Acta Anaesthesiol Scand 1992;36: 656–659.PubMedGoogle Scholar
  36. 36.
    Bromage PR. Epidural Analgesia. Philadelphia: WB Saunders; 1978.Google Scholar
  37. 37.
    Usubiaga JE, Reis AD, Usubiaga LE. Epidural misplacement of catheters and mechanisms of unilateral blockade. Anesthesiology 1970;32:158–161.PubMedGoogle Scholar
  38. 38.
    Hartrick CT, Pither CE, Pai U, Raj PP, Tomsick TA. Subdural migration of an epidural catheter. Anesth Analg 1985;64:175–178.PubMedGoogle Scholar
  39. 39.
    Orbegozo M, Sheikh T, Slogoff S. Subdural cannulation and local anesthetic injection as a complication of anintended epidural anesthetic. J Clin Anesth 1999;11:129–131.PubMedGoogle Scholar
  40. 40.
    Collier CB. Accidental subdural injection during attempted lumbar epidural block may present as a failed or inadequate block: radiographic evidence. Reg Anesth PainMed 2004;29:7–8.Google Scholar
  41. 41.
    Boys JE, Norman PF. Accidental subdural analgesia. Br J Anaesth 1975;47:1111–1113.PubMedGoogle Scholar
  42. 42.
    Blanco D, Llmazares J, Rincön R, Ortiz M, Vidal F. Thoracic epidural anesthesia via the lumbar approach in infants and children. Anesthesiology 1996;84:1312–1316.PubMedGoogle Scholar
  43. 43.
    Blomberg RG. Technical advantages of the paramedian approach forlumbar epidural puncture and catheter introduction. Anaesthesia 1988;43:837–843.PubMedGoogle Scholar
  44. 44.
    Gallart JL, Blanco D, Samsö E, Vidal F. Clinical and radiological evidence of the epidural plica mediana dorsalis. Anesth Analg 1990;71:689–701.Google Scholar
  45. 45.
    Nicholson MJ. Complication associated with the use of extradural catheter in obstetric anesthesia. Anesth Analg 1965;44:245–247.Google Scholar
  46. 46.
    Chun L, Karp M. Unusual complications from placement of catheters in caudal canal in obstetrical anesthesia. Anesthesiology 1966;27:96–97.PubMedGoogle Scholar
  47. 47.
    Browne RA, Politi VL. Knotting of an epidural catheter: a case report. Can Anaesth Soc J 1979;26:142–144.PubMedGoogle Scholar
  48. 48.
    Gozal D, Gozal Y, Beilin B. Removal of knotted epidural catheters. Case reports. Reg Anesth 1996;21:71–73.PubMedGoogle Scholar
  49. 49.
    Hsin ST, Chang FC, Tsou MY, et al. Inadvertent knotting of a thoracic epidural catheter. Acta Anaesthesiol Scand 2001;45:255–257.PubMedGoogle Scholar
  50. 50.
    Riegler R, Pernetzky A. Unremovable epidural catheter due to a sling and a knot. A rare complication of epidural anesthesia in obstetrics [German]. Reg Anaesth 1983;6:19–21.PubMedGoogle Scholar
  51. 51.
    Crawford JS. Some maternal complications of epidural analgesia for labour. Anaesthesia 1985;40:1219–1225.PubMedGoogle Scholar
  52. 52.
    Tanaka S, Sanuki M, Kinoshita H. Accidental severance of epidural catheter used in a patient with postoperative delirium [Japanese]. Masui 2004;53:559–561.PubMedGoogle Scholar
  53. 53.
    Boey SK, Carrie LE. Withdrawal forces during removal of lumbar extradural catheters. Br J Anaesth 1994;73:833–835.PubMedGoogle Scholar
  54. 54.
    Nishio I, Sekiguchi M, Aoyama Y, Asano S, Ono A. Decreased tensile strength of an epidural catheter during its removal by grasping with a hemostat. Anesth Analg 2001;93:210–212.PubMedGoogle Scholar
  55. 55.
    Tsui BC, Finucane B. Tensile strength of 19-and 20-gauge Arrow epidural catheters. Anesth Analg 2003;97:1524–1526.PubMedGoogle Scholar
  56. 56.
    Moir DD, Thorburn J. Obstetric anaesthesia and analgesia. 3rd ed. London: Bailliere Tindall; 1986.Google Scholar
  57. 57.
    Vandermeulen EP, Van Aken H, Vermylen J. Anticoagulants and spinal-epidural anesthesia. Anesth Analg 1994;79:1165–1177.PubMedGoogle Scholar
  58. 58.
    Schmidt A, Nolte H. Subdural and epidural hematomas following epidural anesthesia. A literature review [German]. 1992;41:276–284.Google Scholar
  59. 59.
    Brockmeier V, Moen H, Karlsson BR, Fjeld NB, Reiestad F, Steen PA. Interpleural or thoracic epidural analgesia for pain after thoracotomy. A double blind study. Acta Anaesthesiol Scand 1993;38:317–321.Google Scholar
  60. 60.
    Horlocker TT, Wedel DJ, Benzon H, et al. Regional anesthesia in the anticoagulated patient: defining the risks (the second ASRA Consensus Conference on Neuraxial Anesthesia and Anticoagulation). Reg Anesth Pain Med 2003;28(3):172–197.PubMedGoogle Scholar
  61. 61.
    Rao TLK, El-Etr A A. Anticoagulation following placement of epidural and subarachnoid catheters: an evaluation of neurologic sequelae. Anesthesiology 1981;55:618–620.PubMedGoogle Scholar
  62. 62.
    Ruff RL, Dougherty JH. Complications of lumbar puncture followed by anticoagulation. Stroke 1982;12:879–882.Google Scholar
  63. 63.
    Kee WD, Jones P, Worth RJ. Extradural abscess complicating extradural anaesthesia for caesarean section. Br J Anaesth 1992;69:647–652.Google Scholar
  64. 64.
    Du Pen SL, Petersen DG, Williams A, Bogosian AJ. Infection during chronic epidural catheterization: diagnosis and treatment. Anesthesiology 1990;73:905–909.PubMedGoogle Scholar
  65. 65.
    Nickels JH, Poulos JG, Chaoki K. Risks of infection from short-term epidural catheter use. Reg Anesth 1989;14:88–89.PubMedGoogle Scholar
  66. 66.
    Wanscher M, Riishede L, Krogh B. Fistula formation following epidural catheter. A case report. Acta Anaesthesiol Scand 1985;29:552–553.PubMedGoogle Scholar
  67. 67.
    Schregel W, Hartmann K, Schmitz C, Baumgartner D, Cunitz G. An infected fistula following a peridural catheter [German]. Anaesthesist 1992;41:346–347.PubMedGoogle Scholar
  68. 68.
    Bromage PR. Neurologic complications of regional anesthesia in obstetrics. In: Shnider SM, Levinson G, eds. Anesthesia for Obstetrics. 3rd ed. London: Williams & Wilkins; 1993:433–453.Google Scholar
  69. 69.
    Jakobsen KB, Christensen M-K, Carlsson P. Extradural anaesthesia for repeated surgical treatment in the presence of infection. Br J Anaesth 1995;75:536–540.PubMedGoogle Scholar
  70. 70.
    Carson D, Wildsmith JAW. The risk of extradural abscess [editorial]. Br J Anaesth 1995;75:520–521.PubMedGoogle Scholar
  71. 71.
    Heller AR, Ragaller M, Koch T. Epidural abscess after epidural catheter for pain release during pancreatitis. Acta Anaesthesiol Scand 2000;44:1024–1027.PubMedGoogle Scholar
  72. 72.
    Ansari A, Davies DW, Lohn JW, Culpan P, Etherington G. Extensive epidural abscess associated with an unremarkable recovery. Anaesth Intensive Care 2004;32:825–829.PubMedGoogle Scholar
  73. 73.
    Volk T, Hebecker R, Ruecker G, Perka C, Haas N, Spies C. Subdural empyema combined with paraspinal abscess after epidural catheter insertion. Anesth Analg 2005;100:1222–1223.PubMedGoogle Scholar
  74. 74.
    Baker AS, Ojemann RG, Schwartz MN, Richardson EP Jr. Spinal epidural abscess. N Engl J Med 1975;293:463–468.PubMedGoogle Scholar
  75. 75.
    Stevens RA. Neuraxial blocks. In: Brown DL, ed. Regional Anesthesia and Analgesia. Philadelphia: WB Saunders; 1996.Google Scholar
  76. 76.
    Rosenberg PH, Renkonen OV. Antibacterial activity of bupivacaine and morphine. Anesthesiology 1985;62:178–179.PubMedGoogle Scholar
  77. 77.
    Pere P, Lindgren L, Vaara M. Poor antibacterial effect of ropivacaine: comparison with bupivacaine. Anesthesiology 1999;91:884–886.PubMedGoogle Scholar
  78. 78.
    Kalas DB, Hehre FW. Continuous lumbar peridural anesthesia in obstetrics. VIII. Further observations on inadvertent lumbar puncture. Anesth Analg 1972;51:192–195.PubMedGoogle Scholar
  79. 79.
    Denny N, Masters R, Pearson D, Read J, Sihota M, Seiander D. Postdural puncture headache after continuous spinal anesthesia. Anesth Analg 1987;66:791–794.PubMedGoogle Scholar
  80. 80.
    Pitkänen M. Continuous spinal anaesthesia. Curr Opin Anaesthesiol 1992;5:676–680.Google Scholar
  81. 81.
    Moore DC, Batra MS. The components of an effective dose prior to epidural block. Anesthesiology 1981;55:693–696.PubMedGoogle Scholar
  82. 82.
    Van Zundert A, Vaes L, Soetens M, et al. Every dose given in epidural analgesia for vaginal delivery can be a test dose. Anesthesiology 1987;67:436–440.PubMedGoogle Scholar
  83. 83.
    Cheek TG, Banner R, Sasuter J, Gutsche BB. Prophylactic extradural blood patch is effective. A preliminary communication. Br J Anaesth 1988;61:340–342.PubMedGoogle Scholar
  84. 84.
    Ostheimer GW, Palahniuk RJ, Shnider SM. Epidural blood patch for post-lumbar puncture headache. Anesthesiology 1974;41:307–308.PubMedGoogle Scholar
  85. 85.
    Walpole JB. Blood patch for spinal headache. A recurrence and a complication. Anaesthesia 1975;30:783–785.PubMedGoogle Scholar
  86. 86.
    Scavone BM, Wong CA, Sullivan JT, Yaghmour E, Sherwani SS, McCarthy RJ. Efficacy of a prophylactic epidural blood patch in preventing post dural puncture headache in parturients after inadvertent dural puncture. Anesthesiology 2004;101:1422–1427.PubMedGoogle Scholar
  87. 87.
    Auroy Y, Narchi P, Messiah A, Litt L, Rouvier B, Samii K. Serious complications related to regional anesthesia: results of a prospective survey in France. Anesthesiology 1997;87:479–486.PubMedGoogle Scholar
  88. 88.
    Auroy Y, Benhamou D, Bargues L, et al. Major complications of regional anesthesia in France. The SOS Regional Anesthesia Hotline Service. Anesthesiology 2002;97:1274–1280.PubMedGoogle Scholar
  89. 89.
    Horlocker TT, Abel MD, Messick JM Jr, Schroeder DR. Small risk of serious neurologic complications related to lumbar epidural catheter placement in anesthetized patients. Anesth Analg 2003;96:1547–1552.PubMedGoogle Scholar
  90. 90.
    Bromage PR, Benumof JL. Paraplegia following intracord injection during attempted epidural anesthesia under general anesthesia. Reg Anesth Pain Med 1998;23:104–107.PubMedGoogle Scholar
  91. 91.
    Wilkinson PA, Valentine A, Gibbs JM. Intrinsic spinal cord lesion complicating epidural anaesthesia and analgesia: report of three cases. J Neurol Neurosurg Psychiatry 2002; 72:537–539.PubMedGoogle Scholar
  92. 92.
    Kao MC, Tsai SK, Tsou MY, Lee HK, Guo WY, Hu JS. Paraplegia after delayed detection of inadvertent spinal cord injury during thoracic epidural catheterization in an anesthetized elderly patient. Anesth Analg 2004;99:580–583.PubMedGoogle Scholar
  93. 93.
    Bromage PR, Benumof JL. Safety of epidurals: further comment and response [letter]. Reg Anesth Pain Med 1999;24:274–275.PubMedGoogle Scholar
  94. 94.
    Rosenquist RW, Birnbach DJ. Epidural insertion in anesthetized adults: will your patient thank you? Anesth Analg 2003;96:1545–1546.PubMedGoogle Scholar
  95. 95.
    Drasner K. Thoracic epidural anesthesia: asleep at the wheel? [editorial] Anesth Analg 2004;99:578–579.PubMedGoogle Scholar
  96. 96.
    Motsch J, Hutschenreuter K. Cutaneous cerebrospinal fluid fistula associated with secondary puncture of the dura caused by a peridural catheter [German]. Reg Anaesth 1984;7:74–76.PubMedGoogle Scholar
  97. 97.
    Lin D, Becker K, Shapiro HM. Neurologic changes following epidural injection of potassium chloride and diazepam. A case report with laboratory correlations. Anesthesiology 1986;65:210–212.PubMedGoogle Scholar
  98. 98.
    Liu K, Chia Y-Y. Inadvertent epidural injection of potassium chloride. Report of two cases. Acta Anaesthesiol Scand 1995;39:1134–1137.PubMedGoogle Scholar
  99. 99.
    Forestner JE, Raj PP. Inadvertent epidural injection of thiopental: a case report. Anesth Analg 1975;54:406–407.PubMedGoogle Scholar
  100. 100.
    Yentis SM, Randall K. Drug errors in obstetric anaesthesia: a national survey. Int J Obstet Anesth 2003;12:246–249.PubMedGoogle Scholar
  101. 101.
    Kasaba T, Uehara K, Katsuki H, Ono Y, Takasaki M. Analysis of inadvertent epidural injection of drugs [Japanese]. Masui 2000;49:1391–1394.PubMedGoogle Scholar
  102. 102.
    Krataijan J, Laeni N. Accidental epidural injection of pancuronium. Anesth Analg 2005;100:1546–1547.PubMedGoogle Scholar
  103. 103.
    Rawal N, Van Zundert A, Holmström B, Crowhurst JA. Combined spinal-epidural technique. Reg Anesth 1997;22:406–423.PubMedGoogle Scholar
  104. 104.
    Cook TM. 201 combined spinal-epidurals for anaesthesia using a separate needle technique. Eur J Anaesthesiol 2004;21:679–683.PubMedGoogle Scholar
  105. 105.
    Rawal N, Schollin J, Wesström G. Epidural versus combined spinal epidural block for cesarean section. Acta Anaesthesiol Scand 1988;32:61–66.PubMedGoogle Scholar
  106. 106.
    Carter LC, Popat MT, Wallace DH. Epidural needle rotation and inadvertent dural puncture with catheter. Anaesthesia 1992;47:447–448.PubMedGoogle Scholar
  107. 107.
    Puolakka R, Pitkänen MT, Rosenberg PH. Comparison of technical andblock characteristics of different combined spinal-epidural anesthesia techniques. Reg Anesth Pain Med 2001;26:17–23.PubMedGoogle Scholar
  108. 108.
    Hurley RJ, Lambert DH. Continuous spinal anesthesia with a microcatheter technique: preliminary experience. Anesth Analg 1990;70:97–102.PubMedGoogle Scholar
  109. 109.
    Hurley RJ. Continuous spinal anesthesia: a historical perspective. Reg Anesth 1993;18:390–393.PubMedGoogle Scholar
  110. 110.
    Rosenberg PH. Novel technology: needles, microcatheters, and combined techniques. Reg Anesth 1998;23:363–369.Google Scholar
  111. 111.
    Silvanto M, Pitkänen M, Tuominen M, Rosenberg PH. Technical problems associated with the use of 32-gauge and 22-gauge spinal catheters. Acta Anaesthesiol Scand 1992; 36:295–299.PubMedGoogle Scholar
  112. 112.
    Pitkänen M, Tuominen M, Rosenberg P, Wahlström T. Technical and light microscopic comparison of four different small-diameter catheters used for continuous spinal anesthesia. Reg Anesth 1992;17:288–291.PubMedGoogle Scholar
  113. 113.
    Guinard J-P, Chiolero R, Mavrocordatos P, Carpenter RL. Prolonged intrathecal fentanyl analgesia via 32-gaugecatheters after thoracotomy. Anesth Analg 1993;77:936–941.PubMedGoogle Scholar
  114. 114.
    Jöhr M. Continuous spinal anesthesia using bupivacaine. Report of experience [German]. Reg Anaesth 1988;11:71–73.PubMedGoogle Scholar
  115. 115.
    Van Gessel E, Forster A, Gamulin Z. A prospective study of feasibility in a university hospital. Anesth Analg 1995;80:880–885.PubMedGoogle Scholar
  116. 116.
    De Vera HV, Ries M. Complication of continuous spinal microcatheters: should we seek their removal if sheared? Anesthesiology 1991;74:794.Google Scholar
  117. 117.
    Lindgren L, Silvanto M, Scheinin B, Kauste A, Rosenberg PH. Erythrocyte counts in the cerebrospinal fluid associated with continuous spinal anaesthesia. Acta Anaesthesiol Scand 1995;39:396–400.PubMedGoogle Scholar
  118. 118.
    Horlocker TT, Wedel DJ, Schroeder DR, et al. Preoperative antiplatelet therapy does not increase the risk of spinal hematoma associated with regional anesthesia. Anesth Analg 1995;80:303–309.PubMedGoogle Scholar
  119. 119.
    Standi T, Eckert S, Schulte am Esch J. Microcatheter continuous spinal anaesthesia in the postoperative period: a prospective study of its effectiveness and complications. Eur J Anaesthesiol 1995;12:273–279.Google Scholar
  120. 120.
    Borgeat A, Ekatodramis G, Kalberer F, Benz C. Acute and nonacute complications with interscalene block and shouldersurgery: a prospective study. Anesthesiology 2001;95:875–880.PubMedGoogle Scholar
  121. 121.
    Dullenkopf A, Zingg P, Curt A, Borgeat A. Persistent neurological deficit of the upper extremity after a shoulder operation under general anesthesia combined with a preoperatively placed interscalene catheter [German]. Anaesthesist 2002;51:547–551.PubMedGoogle Scholar
  122. 122.
    Gaumann DM, Lennon RL, Wedel DJ. Continuous axillary block for postoperative pain management. Reg Anesth 1988;13:77–82.Google Scholar
  123. 123.
    Aguilar JL, Domingo V, Samper D, Roca G, Vidal F. Long-term brachial plexus anesthesia using a subcutaneous implantable injection system. Reg Anesth 1995;20:242–245.PubMedGoogle Scholar
  124. 124.
    Ablondi MA, Ryan JF, O’Connell CT, Haley RW. Continuous intercostal nerve blocks for postoperative pain relief. Anesth Analg 1966;45:185–190.PubMedGoogle Scholar
  125. 125.
    Payne KA, Moore SW. Subarachnoid microcatheter anesthesia in children. Reg Anesth 1994;19:237–242.PubMedGoogle Scholar
  126. 126.
    Standi T, Beck H. Radiological examination of the intrathecal position of microcatheters in continuous spinal anaesthesia. Br J Anaesth 1993;71:803–806.Google Scholar
  127. 127.
    Lambert RJ, Hurley RJ. Cauda equina syndrome and continuous spinal anesthesia. Anesth Analg 1991;72:817–819.PubMedGoogle Scholar
  128. 128.
    Lambert LA, Lambert DH, Strichartz GR. Irreversible conduction block in isolated nerve by high concentration of local anesthetics. Anesthesiology 1994;80:1082–1093.PubMedGoogle Scholar
  129. 129.
    Pitkänen M. Continuous spinal anesthesia and analgesia. Tech Reg Anesth Pain Manage 1998;2:96–102.Google Scholar
  130. 130.
    Puolakka R, Pitkänen MT, Rosenberg PH. Comparison of three catheter sets for continuous spinal anesthesia in patients undergoing total hip or knee arthroplasty. Reg Anesth Pain Med 2000;25:584–590.PubMedGoogle Scholar
  131. 131.
    Tuominen M, Pere P, Rosenberg PH. Unintentional arterial catheterization and bupivacaine toxicity associated with continuous interscalene brachial plexus block. Anesthesiology 1991;75:356–358.PubMedGoogle Scholar
  132. 132.
    Winnie AR Plexus Anesthesia. Vol 1. Fribourg: Mediglobe SA; 1990.Google Scholar
  133. 133.
    Kapral S, Krafft P, Eisenberger K, Fitzgerald R, Gosch M, Weinstabl C. Ultrasoundguided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth Analg 1994;78:507–513.PubMedGoogle Scholar
  134. 134.
    Chan VW. Applying ultrasound imaging to interscalene brachial plexus block. Reg Anesth Pain Med 2003;28:340–343.PubMedGoogle Scholar
  135. 135.
    Boezaart AP, De Beer J F, Nell ML. Early experience with continuous cervical paravertebral block using a stimulating catheter. Reg Anesth Pain Med 2003;28:406–413.PubMedGoogle Scholar
  136. 136.
    Tuominen M, Haasio J, Hekali R, Rosenberg PH. Continuous interscalene brachial plexus block: clinical efficacy, technical problems and bupivacaine plasma concentrations. Acta Anaesthesiol Scand 1989;33:84–88.PubMedGoogle Scholar
  137. 137.
    Hubner T, Gerber H. Knotting of a catheter in the plexus brachialis. A rare complication [German]. Anaesthesist 2003;52:606–607.PubMedGoogle Scholar
  138. 138.
    Urmey WF, Talts KH, Sharrock NE. One hundred percent incidence of hemidiaphragm paresis with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Anesth Analg 1991;72:498–503.PubMedGoogle Scholar
  139. 139.
    Pere PJ, Pitkänen MT, Rosenberg PH, et al. Effect of continuous interscalene brachial plexus block on diaphragmatic motion and on ventilatory function. Acta Anaesthesiol Scand 1992;36:53–57.PubMedGoogle Scholar
  140. 140.
    Farrar MD, Scheybani M, Nolte H. Upper extremity block effectiveness and complications. Reg Anesth 1981;6:133–134.Google Scholar
  141. 141.
    Pere P. The effect of continuous interscalene brachial plexus block with 0.125% bupivacaine plus fentanyl on diaphragmatic motility and ventilatory function. Reg Anesth 1993; 18:93–97.PubMedGoogle Scholar
  142. 142.
    Rosenberg PH, Lamberg TS, Tarkkila P, Marttila T, Björkenheim J-M, Tuominen M. Auditory disturbances associated with interscalene brachial plexus block. Br J Anaesth 1995;74:89–91.PubMedGoogle Scholar
  143. 143.
    Mahoudeau G, Gaertner E, Launoy A, Ocquidant P, Loewenthal A. Interscalenic block: accidental catheterization of the epidural space [French]. Ann Fr Anesth Reanim 1995;14:438–441.PubMedGoogle Scholar
  144. 144.
    Moore DC, Bridenbaugh LD. Pneumothorax, its incidence following intercostal nerve block. JAMA 1962;182:135–138.Google Scholar
  145. 145.
    Shanti CM, Carlin AM, Tyburski JG. Incidence of pneumothorax from intercostal nerve block for analgesia in rib fractures. J Trauma 2001;51:536–539.PubMedGoogle Scholar
  146. 146.
    O’Kelly E, Garry B. Continuous pain relief for multiple fractured ribs. Br J Anaesth 1981;53:989–991.Google Scholar
  147. 147.
    Crossley AWA, Hosie HE. Radiographic study of intercostal nerve block in healthy volunteers. Br J Anaesth 1987;59:149–154.PubMedGoogle Scholar
  148. 148.
    Mowbray A, Wong KKS, Murray JM. Intercostal catheterization. An alternative to the paravertebral space. Anaesthesia 1987;42:958–961.PubMedGoogle Scholar
  149. 149.
    Kawamata M, Omote K, Namiki A, Miyabe M. Measurement of intercostal and pleural pressures by epidural catheter. Anaesthesia 1994;49:208–210.PubMedGoogle Scholar
  150. 150.
    Ouvert RT, Nauss LA, Payne S. A technique for continuous intercostal nerve block analgesia following thoracotomy. J Thorac Cardiovasc Surg 1980;80:308–311.Google Scholar
  151. 151.
    Sabanathan S, Smith PJ, Pradhan GN, Hashimi H, Eng JB, Mearns AJ. Continuous intercostal nerve block for pain relief after thoracotomy. Ann Thorac Surg 1988;46: 425–426.PubMedGoogle Scholar
  152. 152.
    Tenicela R, Pollan SB. Paravertebral-peridural block technique: a unilateral thoracic block. Clin J Pain 1990;6:227–234.PubMedGoogle Scholar
  153. 153.
    Naja Z, Lönnqvist PA. Somatic paravertebral nerve blockade. Incidence of failed block and complications. Anaesthesia 2001;56:1184–1188.PubMedGoogle Scholar
  154. 154.
    Dhole S, Mehta Y, Saxene H, Juneja R, Trehan N. Comparison of continuous thoracic epidural and paravertebral blocks for postoperative analgesia after minimally invasive direct coronary artery bypass surgery. J Cardiothorac Vase Anesth 2001;15:288–292.Google Scholar
  155. 155.
    Marret E, Bazelly B, Taylor G, et al. Paravertebral block with ropivacaine 0.5% versus systemic analgesia for pain relief after thoracotomy. Ann Thorac Surg 2005;79:2109–2114.PubMedGoogle Scholar
  156. 156.
    Eason M J, Wyatt R. Paravertebral thoracic block — a reappraisal. Anaesthesia 1979;34: 638–642.PubMedGoogle Scholar
  157. 157.
    Strømskag KE, Minor B, Steen PA. Side effects and complications related to interpleural analgesia: an update. Acta Anaesthesiol Scand 1990;34:473–477.PubMedGoogle Scholar
  158. 158.
    Symreng T, Gomez MN, Johnson B, Rossi NP, Chiang CK. Intrapleural bupivacaine technical considerations and intraoperative use. J Cardiothorac Anesth 1989;3:139–143.PubMedGoogle Scholar
  159. 159.
    Murrell G. A new complication of the intrapleural catheter method for postoperative analgesia. Anaesth Intensive Care 1988;16:499–500.Google Scholar
  160. 160.
    Rosenberg PH, Scheinin BM, Lepäntalo MJ, Lindfors O. Continuous interpleural infusion of bupivacaine for analgesia after thoracotomy. Anesthesiology 1987;67:811–813.PubMedGoogle Scholar
  161. 161.
    Lauder GR. Interpleural analgesia and phrenic nerve paralysis. Anaesthesia 1993;48: 315–316.PubMedGoogle Scholar
  162. 162.
    Parkinson SK, Mueller JB, Rich TJ, Little WL. Unilateral Horner’s syndrome associated with interpleural catheter injection of local anesthetic. Anesth Analg 1989;68:61–62.PubMedGoogle Scholar
  163. 163.
    Reiestad F, Mcllvane WB, Kvalheim L, Stokke T, Pettersen B. Interpleural analgesia in treatment of upper extremity reflex sympathetic dystrophy. Anesth Analg 1989;69:671–673.PubMedGoogle Scholar
  164. 164.
    Karakaya D, Baris S, özkan F, et al. Analgesie effect of interpleural bupivacaine with fentanyl for post-thoracotomy pain. J Cardiothorac Vase Anesth 2004;18:461–465.Google Scholar
  165. 165.
    Rosenblatt RM. Continuous femoral anesthesia for lower extremity surgery. Anesth Analg 1980;59:631–632.PubMedGoogle Scholar
  166. 166.
    Postel J, März P. Continuous blockade of the lumbar plexus (“3-in-l block”) in perioperative pain therapy [German]. Reg Anaesth 1984;7:140–143.PubMedGoogle Scholar
  167. 167.
    Jöhr M. A complication of continuous blockade of the femoral nerve [German]. Reg Anaesth 1987;10:37–38.PubMedGoogle Scholar
  168. 168.
    AI-Nasser B, Palacios JL. Femoral nerve injury complicating psoas compartment block. Reg Anaesth Pain Med 2004;29:361–363.Google Scholar
  169. 169.
    Pousman RM, Mansoor Z, Sciard D. Total spinal anesthetic after continuous posterior lumbar plexus block. Anesthesiology 2003;98:1281–1282.PubMedGoogle Scholar
  170. 170.
    Litz RJ, Vicent O, Wiessner D, Heller AR. Misplacement of a psoas compartment catheter in the subarachnoid space. Reg Anesth Pain Med 2004;29:60–64.PubMedGoogle Scholar
  171. 171.
    Rotzinger M, Neuburger M, Kaiser H. Inadvertent epidural placement of a psoas compartment catheter. Case report of a rare complication [German]. Anaesthesist 2004;53: 1069–1072.PubMedGoogle Scholar
  172. 172.
    Compere V, Cornet C, Fourdrinier V, et al. Thigh abscess as a complication of continuous popliteal sciatic nerve block. Br J Anaesth 2005;95(2):255–256.PubMedGoogle Scholar
  173. 173.
    Bickler P, Brandes J, Lee M, Bozic K, Chesbro B, Claassen J. Bleeding complications from femoral and sciatic nerve catheters in patients receiving low molecular weight heparin. Anesth Analg 2006;103:1036–1037.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Per H. Rosenberg
    • 1
  1. 1.Department of Anesthesiology and Intensive Care MedicineHelsinki UniversityHelsinkiFinland

Personalised recommendations