Surgical removal of a looped and knotted epidural catheter in a postpartum patient--a case report.

We report a case of unsuccessful removal of an epidural catheter in a postpartum patient following a labour epidural analgesia, which ultimately required surgical intervention and fenestration ligamentum flavum to remove the epidural catheter. A 26 year old, requested an epidural analgesia for her labour pain. The epidural catheter was inserted under aseptic technique, and she was comfortable throughout her labour and had a normal vaginal delivery 4 hours later. One hour later, the acute pain nurse tried to remove the epidural catheter and encountered difficulty, she reported this to the resident on call, who also tried and found it unusually difficult to remove. A senior consultant was involved where he found a high resistance, several methods had been tried unsuccessfully. Surgical removal was the option, patient and partner were informed and consented, a neurosurgeon was consulted. Through a small incision (1 inch) a fenestration of ligamentum flavum was performed and a knotted and looped epidural catheter was removed. Patient was discharged next day, and in the follow up and subsequent visits patient remained well with no other complaints.