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Canadian Journal of Anesthesia 51:192 (2004)
© Canadian Anesthesiologists' Society, 2004

Correspondence

What do we do with a disconnected epidural catheter? - A response

Shaul Cohen, MD, Ashraf Sakr, MD and Ehab Sakr, MD

New Brunswick, New Jersey

To the Editor:

We read with interest the letter of Parry1 concerning disconnection between the epidural catheter and its luer-lock connector. We would like to comment on a simple technique to reduce if not eliminate this problem.

In our practice, we use an Arrow FlexTip Plus® catheter (Arrow International, Inc., Reading, PA, USA) which is attached to Arrow’s SnapLockTM adapter (Arrow International, Inc., Reading, PA, USA) by a single "snap." Other catheters with a screw cap may not be tightened enough on the catheter and have the potential to disconnect.

The catheter is then taped with a double loop to the adapter as described by Rivard et al.2 Once the adapter is connected to the tubing of the epidural pump, the epidural catheter along with the adapter and the pump tubing are looped and taped to the patient’s shoulder. We check if the epidural catheter is secured properly every hour for labour and delivery, and twice a day post-Cesarean section.

We apply this technique for labour epidural, as well as post-Cesarean section epidural-patient controlled analgesia infusion for up to three to four days. We have used this technique for more than 500 patients a year for five years, without any incidence of epidural disconnection.

References

1 Parry G. What do we do with a disconnected epidural catheter? (Letter). Can J Anesth 2003; 50: 523.[Free Full Text]

2 Rivard S, Dorje P, Steude G. Preventing epidural catheter disconnection (Letter). Reg Anesth 1994; 19: 363–4.





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