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February 1959

Perforation of Dura by a Plastic Catheter During Continuous Caudal Anesthesia

Author Affiliations

Columbus, Ohio
Department of Surgery (Anesthesia), The Ohio State University College of Medicine.; Present address: Medical College of South Carolina, Charleston, S. C. (Dr. Hamelberg).

AMA Arch Surg. 1959;78(2):357-358. doi:10.1001/archsurg.1959.04320020179027

Occasional perforation of the dura is a well-recognized possibility following the insertion of a needle into the caudal canal. Perforation of the dura by a plastic catheter passed through a needle in the caudal canal is rare. A review of the literature discloses several reports of dural perforation using malleable needles, but none following the use of a plastic catheter. The following is a case report of such an occurrence.

Report of Case  The patient, a 60-year-old man, was admitted for elective repair of bilateral inguinal hernia. The past history was relevant in that 43 years prior to admission the patient had had rheumatic fever, resulting in rheumatic heart disease. At the time of surgery, he had mitral stenosis and at rial fibrillation without evidence of cardiac failure. An electrocardiogram showed left ventricular hypertrophy, auricular fibrillation, premature ventricular extrasystoles, and an old posterior myocardial infarct. All other physical and laboratory

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