Journal of Anaesthesiology Clinical Pharmacology

: 2012  |  Volume : 28  |  Issue : 3  |  Page : 416--417

A stitch in time saves nine

Ritu Aggarwal, Sandhya Agarwal 
 Department of Anaesthesia, Deen Dayal Upadhyay Hospital, New Delhi, India

Correspondence Address:
Ritu Aggarwal
D-226 first floor, Sarvodaya Enclave, New Delhi - 110 017

How to cite this article:
Aggarwal R, Agarwal S. A stitch in time saves nine.J Anaesthesiol Clin Pharmacol 2012;28:416-417

How to cite this URL:
Aggarwal R, Agarwal S. A stitch in time saves nine. J Anaesthesiol Clin Pharmacol [serial online] 2012 [cited 2020 Jul 3 ];28:416-417
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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}{Figure 2}