{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:41:08Z","timestamp":1792424468408,"version":"4.5.0"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":89,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unintentional intrathecal catheter placement is a recognized complication of labor neuraxial analgesia. Although continuous spinal analgesia (CSA) may be used as a management option, prompt recognition, careful catheter management, and close monitoring are required to prevent complications such as severe spinal anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 31-year-old primigravida underwent combined spinal-epidural analgesia for labor pain. Intrathecal catheter placement was diagnosed after a test dose was administered based on hypotension, motor weakness, sensory block, and glucose-positive aspirated fluid. The catheter was managed as CSA with fentanyl-based analgesia under strict monitoring. Although frequent breakthrough pain required rescue boluses, the vaginal delivery was achieved uneventfully. The patient developed a post-dural puncture headache that resolved after an epidural blood patch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case illustrates the importance of early recognition of inadvertent intrathecal catheter placement and demonstrates that safe labor analgesia can be achieved through conversion to CSA with careful catheter management and close monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40981-026-00869-1","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:44:59Z","timestamp":1784724299000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early recognition and safe management of unintentional intrathecal placement of an epidural catheter during combined spinal-epidural labor analgesia: a case report in the context of the 2024 OAA guidelines"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6272-7307","authenticated-orcid":false,"given":"Hidenobu","family":"Watanabe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choko","family":"Kume","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arisa","family":"Ijuin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Yamashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiko","family":"Ohara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"12","key":"869_CR1","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1111\/anae.16434","volume":"79","author":"SK Griffiths","year":"2024","unstructured":"Griffiths SK, Russell R, Broom MA, Devroe S, Van de Velde M, Lucas DN. Intrathecal catheter placement after inadvertent dural puncture in the obstetric population: management for labour and operative delivery. Guidelines from the Obstetric Anaesthetists\u2019 Association. Anaesthesia. 2024;79(12):1348\u201368.","journal-title":"Anaesthesia"},{"issue":"8","key":"869_CR2","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1111\/anae.15390","volume":"76","author":"S Orbach-Zinger","year":"2021","unstructured":"Orbach-Zinger S, Jadon A, Lucas DN, Sia AT, Tsen LC, Van de Velde M, et al. Intrathecal catheter use after accidental dural puncture in obstetric patients: literature review and clinical management recommendations. Anaesthesia. 2021;76(8):1111\u201321.","journal-title":"Anaesthesia"},{"issue":"3","key":"869_CR3","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.ijoa.2007.05.015","volume":"17","author":"M Camorcia","year":"2008","unstructured":"Camorcia M, Capogna G, Columb MO. Estimation of the minimum motor blocking potency ratio for intrathecal bupivacaine and lidocaine. Int J Obstet Anesth. 2008;17(3):223\u20137.","journal-title":"Int J Obstet Anesth"},{"issue":"5 Pt 1","key":"869_CR4","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1007\/BF03011937","volume":"44","author":"DS Walker","year":"1997","unstructured":"Walker DS, Brock-Utne JG. A comparison of simple tests to distinguish cerebrospinal fluid from saline. Can J Anaesth. 1997;44(5 Pt 1):494\u20137.","journal-title":"Can J Anaesth"},{"issue":"6","key":"869_CR5","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1007\/s00540-016-2238-6","volume":"30","author":"S Hyuga","year":"2016","unstructured":"Hyuga S, Okutomi T, Kato R, Hosokawa Y. Continuous spinal labor analgesia for two deliveries in a parturient with severe subvalvular aortic stenosis. J Anesth. 2016;30(6):1067\u201370.","journal-title":"J Anesth"},{"issue":"7","key":"869_CR6","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1136\/rapm-2023-104817","volume":"49","author":"V Uppal","year":"2024","unstructured":"Uppal V, Russell R, Sondekoppam RV, Ansari J, Baber Z, Chen Y, et al. Evidence-based clinical practice guidelines on postdural puncture headache: a consensus report from a multisociety international working group. Reg Anesth Pain Med. 2024;49(7):471\u2013501.","journal-title":"Reg Anesth Pain Med"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-026-00869-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-026-00869-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-026-00869-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:03:29Z","timestamp":1792422209000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-026-00869-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["869"],"URL":"https:\/\/doi.org\/10.1186\/s40981-026-00869-1","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"assertion":[{"value":"5 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This case report did not require institutional review board approval according to our institution\u2019s policy. Written informed consent was obtained from the patient.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient for publication of this case report.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"36"}}