Removal of knotted epidural catheters: Case reports

Background and Objectives. An epidural anesthetic was planned for a 24- year-old woman for analgesia during labor and for a 28-year-old woman for an elective cesarean delivery. Methods. Two cases of inability to remove an epidural catheter due to a knot are reported. The epidural catheter was initially inserted 6 and 8 cm, respectively, into the epidural space. Attempts to remove the catheter by gentle traction remained unsuccessful. Results. In the first case, the catheter was removed successfully by using general anesthesia with succinylcholine, and in the second case the catheter was removed by pulling it out slowly. Conclusions. To prevent the knotting of an epidural catheter, it should not be inserted more than 3-4 cm into the epidural space. General anesthesia may be one of the options to remove the catheter.