Persistent Cutaneous Fluid Leakage from Epidural Puncture Site: A Diagnostic Challenge

[摘要] A 60‑year‑old female patient of weight 90 kg, height168 cm, and ASA grade II was scheduled for bilateraltotal knee replacement surgery. The epidural space wasidentified at the L3–L4 intervertebral space using the lossof resistance technique with a 16G Tuohy needle, at 4.5 cmfrom the skin, by the midline approach, in a sitting position.15 mg of injection bupivacaine heavy was given in thesubarachnoid space using a 27G Whitacre spinal needle byneedle through needle technique. The epidural catheter wassecured at 9.5 cm at the level of the skin, and a test doseof 45 mg of lignocaine with adrenaline 15 µg was injectedwithout adverse effect. The surgery was completed in 3 huneventfully. Postoperatively, injection bupivacaine 0.125%was given as boluses for pain relief. On the 3rd postoperativeday, the epidural catheter was found to be removedaccidentally. The next day, clear liquid was seen leakingfrom the epidural catheter puncture site.

[学科分类] 分子生物学，细胞生物学和基因