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Removing an epidural catheter rarely poses any technical difficulty. Few anaesthesiologists or Advanced Practice Nurses (APNs) having expertise in surgical pain management have personal experience in dealing with epidural catheters that cannot be removed by gentle traction. The cause and location of the epidural entrapment is seldom apparent and the optimum approach to its extraction while avoiding catheter breakage is not evident. Catheter entrapment is known complication of epidural analgesia and may occur at the all levels of the epidural space. Proposed management of the entrapped epidural catheter includes visualization of the catheter by fluoroscopy, CT or MRI and based on the imaging findings may require removal of the catheter surgically. Non-surgical options include trying to remove the catheter while placing the patient in a variety of positions including the insertion, lateral decubitus, extreme flexion and extension positions and the injection of preservative-free normal saline through the catheter. A guide wire can also be used for the non-surgical removal of trapped epidural catheters.
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