{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:27:05Z","timestamp":1787840825270,"version":"build-2784847793"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Lumbar epidural anesthesia is an important part of labor analgesia. Despite common complications, lumbar epidurals are considered the most effective pain management option during childbirth. Fracture of the epidural catheter during removal is an uncommon but known complication, but fragmentation of the catheter during insertion is extremely uncommon. There are several reasons for catheter fracture during removal; however, catheter fracture during insertion can occur for two main reasons in labor epidurals. The first reason is if the anesthetist pulls the catheter while the Tuohy needle is still in place, and the second is when the catheter is removed during active labor contractions. We describe the occurrence of such an event in a primiparous patient, where the epidural catheter fractured during insertion. A brief review is provided to prevent and manage such complications.<\/jats:p>","DOI":"10.4103\/sja.sja_289_25","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:00:57Z","timestamp":1756900857000},"page":"655-657","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Fragmentation of epidural catheter-need consensus on management"],"prefix":"10.4103","volume":"19","author":[{"given":"Rekha","family":"Bhatia","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Somerset NHS Foundation Trust, Yeovil, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saumitra","family":"Zope","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Somerset NHS Foundation Trust, Yeovil, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prachi","family":"Ganokar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Somerset NHS Foundation Trust, Yeovil, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupak","family":"Kundu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Somerset NHS Foundation Trust, Yeovil, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"R1-20260421","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1054\/ijoa.1999.0354","article-title":"Epidural catheter breakage: A possible mechanism","volume":"9","author":"Collier","year":"2000","journal-title":"Int J Obstet Anesth"},{"key":"R2-20260421","first-page":"116","article-title":"Broken epidural catheter: An anesthesiologist\u2019s dilemma","volume":"7","author":"Sardana","year":"2017","journal-title":"J Case Rep"},{"key":"R3-20260421","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1055\/s-0035-1549030","article-title":"Delayed onset of subdural hematoma following epidural catheter breakage","volume":"6","author":"Ishikawa","year":"2015","journal-title":"Global Spine J"},{"key":"R4-20260421","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/j.1460-9592.1992.tb00224.x","article-title":"Retained caudal catheter in a pediatric patient","volume":"2","author":"De Armendi","year":"1992","journal-title":"Paediatr Anesth"},{"key":"R5-20260421","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1093\/bja\/ael027","article-title":"Subcutaneous effusion resulting from an epidural catheter fragment","volume":"96","author":"Demiraran","year":"2006","journal-title":"Br J Anaesth"},{"key":"R6-20260421","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.jclinane.2006.11.005","article-title":"Management of the sheared epidural catheter: Is surgical extraction really necessary?","volume":"19","author":"Metra","year":"2007","journal-title":"J Clin Anesth"},{"key":"R7-20260421","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1097\/00000542-199511000-00027","article-title":"Lumbar stenosis complicating retained epidural catheter tip","volume":"83","author":"Stats","year":"1995","journal-title":"Anesthesiology"},{"key":"R8-20260421","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1097\/00115550-200209000-00015","article-title":"Computed tomography images of entrapped epidural catheter","volume":"27","author":"Dam-Hieu","year":"2002","journal-title":"Reg Anesth Pain Med"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_289_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:29:43Z","timestamp":1787837383000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_289_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,3]]},"references-count":8,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_289_25","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,3]]},"assertion":[{"value":"2025-04-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}