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LETTER TO EDITOR
Year : 2012  |  Volume : 28  |  Issue : 3  |  Page : 416-417

A stitch in time saves nine


Department of Anaesthesia, Deen Dayal Upadhyay Hospital, New Delhi, India

Date of Web Publication11-Jul-2012

Correspondence Address:
Ritu Aggarwal
D-226 first floor, Sarvodaya Enclave, New Delhi - 110 017
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9185.98381

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How to cite this article:
Aggarwal R, Agarwal S. A stitch in time saves nine. J Anaesthesiol Clin Pharmacol 2012;28:416-7

How to cite this URL:
Aggarwal R, Agarwal S. A stitch in time saves nine. J Anaesthesiol Clin Pharmacol [serial online] 2012 [cited 2019 May 23];28:416-7. Available from: http://www.joacp.org/text.asp?2012/28/3/416/98381

Sir,

We would like to report a case of successful use of pediatric epidural (PE) catheter despite its shearing at the proximal end. A 14 kg, 4-year-old girl was scheduled for right anterolateral thigh flap surgery. Patient was administered general anesthesia as per the standard guidelines followed by the insertion of 22G (internal diameter 0.3 mm and external diameter 0.7 mm) caudal PE catheter (Vygon, Ecouen, France) [Figure 1] as per the standard procedure. While introducing the scalp vein needle of the PE set into the catheter, unfortunately it got sheared. We cut the catheter near the sheared end and tried to insert the needle back into the cut-end. To our surprise this was not possible. We cut the end obliquely in order to increase the surface area but were again unsuccessful at inserting the needle within. We successfully inserted a 26G hypodermic needle into the catheter [Figure 2] and with this assembly were able to give effective intraoperative and postoperative analgesia to the patient rather than abandoning or redoing the whole procedure. The 27G scalp vein needle could not be re-introduced into the catheter because it has a blunt end and its external diameter (0.4 mm) is more than the internal diameter of the catheter (0.3 mm). The hypodermic 26G needle could easily be introduced into the catheter because of its bevelled end, though there was a possibility that the sharp end of the bevel could pierce into the catheter during use.
Figure 1: Pediatric epidural set showing scalp vein needle at the proximal end

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Figure 2: 26G hypodermic needle as a replacement for 27G scalp vein of the epidural set

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    Figures

  [Figure 1], [Figure 2]



 

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