American Society of Regional Anesthesia and Pain Medicine November 2017 - 24

small volume of contrast material under fluoroscopic guidance.
Imaging would provide guidance as to the safest means of
removing the catheter.

catheter and document in the patient's medical record. Unless the
retained catheter caused symptoms, I would not push forward with
any further evaluation.

Dr Pawa: I would cease pulling and ask for a surgical opinion.

Dr Maniker: I would obtain imaging (bedside ultrasound and
possible computed tomography) and consider obtaining a surgery
consult for exploration and removal.

How would you proceed if you attempted to remove the
catheter and you think you left a portion behind in the patient?
Dr Auyong: If a portion of the catheter was left behind in
the patient, I would first and foremost inform the patient. If
asymptomatic, I would reassure the patient that retained foreign
bodies are generally not removed surgically. I would examine the
patient with ultrasound to see if I could locate any part of the

24

Dr Harrington: A surgical consult would be obtained for open
removal of the broken fragment.
Dr Pawa: I would organize imaging and a consultation with my
surgical colleagues, with a view to facilitate surgical removal if
required.

American Society of Regional Anesthesia and Pain Medicine
2017



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