Unsuspected intravascular migration of a thoracic epidural catheter in a thoracotomy patient: A case report

ABSTRACT

Thoracic epidural analgesia is the most effective method of managing post-thoracotomy pain. However, the catheter may be misplaced into the intrapleural, intercostal, subarachnoid, or intravascular space. Intravascular misplacement of a catheter can be detected by aspiration of blood or administration of a test dose of local anesthetic; however, these methods may result in a false-negative response. Moreover, a catheter placed in the epidural space may migrate into a blood vessel during the intraoperative period. Thus, the location of the catheter tip should always be determined before local anesthetic is administered. We report a case of intraoperative intravascular migration of a thoracic epidural catheter in a 32-year-old male who underwent left thoracotomy.