Shearing and Migration of Interscalene Catheter After an Uncomplicated Ultrasound Guided Placement

Vol 2 | Issue 2 | July-December 2021 | Page 137-140 | Shashank Rane, Vijay Shetty, Sitaram Prasad, Rajat Bhargava

DOI: 10.13107/ijra.2021.v02i02.042


Authors: Shashank Rane [1], Vijay Shetty [1], Sitaram Prasad [2], Rajat Bhargava [3]

[1] Department of Anaesthesia, Fortis Hospital, Mumbai, Maharashtra, India.
[2] Department of Plastic Surgery, Fortis Hospital, Mumbai, Maharashtra, India.
[3] Department of Radiology, Fortis Hospital, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Shashank Rane,
Department of Anaesthesia, Fortis Hospital, Mumbai, Maharashtra, India.
E-mail: shankrane81@gmail.com


Abstract


We report on the case of shearing and migration of an interscalene nerve catheter in 68- year-old female who underwent a left shoulder surgery. The catheter was placed under ultrasound guidance without any apparent complications. Continuous interscalene nerve block was successfully used to complement General Anaesthesia and provide postoperative pain relief. On the second day, at the time of catheter removal, the catheter inadvertently sheared at the point of insertion with the distal 7 centimetres migrating under the skin. The axial and coronal CT scan sections confirmed the migration of the catheter posterolateral to subclavian artery in the vicinity of the Brachial plexus. Patient did not have any pain or neurological deficit. Surgery was performed to extract the catheter, which was found in brachial plexus sheath between lower end of Scalenus Anterior and Scalenus Medius.
Keywords: Interscalene catheter, Shearing, Migration


References


1. Capdevila X, Pirat P, Bringuier S, et al. Continuous peripheral nerve blocks in hospital wards after orthopedic surgery: A multicenter prospective analysis of the quality of postoperative analgesia and complications in 1,416 patients. Anesthesiology 2005;103:1035–45.
2. Ates Y, Yucesoy CA, Unlu MA, Saygin B, Akkas N. The mechanical properties of intact and traumatized epidural catheters. Anesth Analg 2000;90:393–9.
3. Hadzic A, ed. New York School of Regional Anesthesia. Textbook of Regional Anesthesia and Acute Pain Management. New York: McGraw-Hill Medical Pub. Division; 2007:412–3.
4. Despond O, Kohut GN. Broken interscalene brachial plexus catheter: surgical removal or not? Anesth Analg. 2010 Feb 1;110(2):643-4. doi: 10.1213/ane.0b013e3181c62a05. PMID: 20081147.
5. Mitra R, Fleischmann K. Management of the sheared epidural catheter: Is surgical extraction really necessary? J Clin Anesth 2007;19:310–4.
6.  Bowens C Jr, Briggs ER, Malchow RJ. Brachial plexus entrapment of interscalene nerve catheter after uncomplicated ultrasound-guided placement. Pain Med. 2011;12:1117-20.
7. Ilfeld BM, Morey TE, Enneking FK. Infraclavicular perineural local anesthetic infusion: A comparison of three dosing regimens for postoperative analgesia. Anesthesiology 2004;100:395–402.
8. Brenier G, Salces A, Magues JP, Fuzier R. Peripheral nerve catheter entrapment is not always related to knotting. Can J Anaesth 2010;57:183–4.


How to Cite this Article: Rane S, Shetty V, Prasad S, Bhargava R | Shearing and Migration of Interscalene Catheter After an Uncomplicated Ultrasound Guided Placement | International Journal of Regional Anaesthesia | July-December 2021; 2(2): 137-140.

 


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