UNINTENTIONAL PLEURAL PUNCTURE AFTER THORACIC EPIDURAL - A CASE REPORT
Abstract
Thoracic epidural analgesia is one of the most effective and time tested modalities of
providing effective post-thoracotomy pain relief. It also reduces postoperative pulmonary
complications like atelectasis, impaired coughing, retention of secretions, infections etc.
Nevertheless, being a blind procedure several complications have been associated with the
technique. Pleural puncture is one rare complication that might occur following thoracic epidural
catheterisation. This case report is about a 55yr old male who underwent thoracotomy for excision of
right lung emphysematous bulla under general anaesthesia with thoracic epidural block. During
surgery the catheter tip was found to be in the right pleural cavity. There was no evidence of bleeding
or lung injury around the puncture site. The catheter was left in situ and was utilised to provide post
operative intrapleural analgesia with local anaesthetic. We have discussed probable reasons for
pleural puncture during epidural blockade and certain precautions which could possibly prevent
technique related complications.
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