Epidural catheter anchored in the posterior lateral epidural space: How to manage it. / Anclaje del catéter epidural en el espacio epidural posterolateral: cómo manejarlo.

We describe a case of an epidural catheter entrapment without knotting, kinking, shearing or breakage confirmed by CT scan and how to manage it. A patient was admitted for tibial fracture repair under general anesthesia with an epidural. At discharge day, multiple attempts to retrieve the catheter were made. Contrast CT scan showed the catheter anchored in the left posterior-lateral epidural space. Despite the absence of guidelines regarding epidural catheter entrapment, all the methods described in the literature were used. This is a rare complication and it may be associated with neurological and infectious complications. Radiologic imaging should be obtained to better characterize the catheters' position and plan removal. In this case, tension in the paraspinal muscles or in the supraspinous and intraspinous ligaments could explain the entrapment. General anesthesia with the non-depolarising muscle relaxant allowed muscles and ligaments to relax and we were able to retrieve the catheter intact.

Aplicaciones del monitoreo intraoperatorio de pares craneales: uso en cirugía de cabeza y cuello / Intraoperative monitoring applications cranial nerves: use in head and neck surgery

El monitoreo intraoperatorio de nervios es una herramienta “relativamente” nueva, que ayuda al cirujano a identificar y preservar nervios en áreas anatómicas alteradas o que han sido intervenidas antes. En otorrinolaringología y cirugía de cabeza y cuello se usó primero para el tratamiento del neuroma del acústico; sin embargo, en la actualidad sus indicaciones se han ampliado. Esta técnica se usa de manera especial en cirugía de parótida y tiroides, con el fin de preservar el nervio facial y los nervios laríngeo superior e inferior (recurrente). Se hace una descripción del proceso y de los diferentes pasos que se siguen para utilizar la técnica…

Intraoperative nerve monitoring is a relatively new tool that helps the surgeon identify and preserve nerves in areas with difficult anatomical access or which have been previously operated on. In Otolaryngology, head and neck surgery was used initially, in the treatment of acoustic neuroma; however, today its applications have become wider, especially in the surgery of the parotid and thyroid glands to preserve the facial nerve and the superior and inferior (recurrent) laryngeal nerve. A description of the process and the steps involved when this technique is used is given…