Incidence of Accidental Dural Perforation, Sanguineous Puncture, and Unsuccessful Catheter Placement and Their Predictors During Epidural Catheterization: A Prospective Observational Study

Authors

  • Prakash Karki Department of Anaesthesiology, Buddha International Hospital. Dang, Nepal
  • Kishor Khanal Department of Critical Care, Nepal Mediciti, Lalitpur, Nepal
  • Pradeep Tiwari Department of Critical Care, Civil Service Hospital, Kathmandu, Nepal
  • Pankaj Joshi Department of Anesthesiology, Tribhuwan University Teaching Hospital, Kathmandu, Nepal
  • Krishna Acharya Department of Anesthesiology, National Trauma Center, Kathmandu, Nepal

Keywords:

Epidural anaesthesia, dural puncture, catheter failure, complications

Abstract

BACKGROUND Epidural anaesthesia is widely used for perioperative analgesia, yet immediate complications such as accidental dural perforation (ADP), sanguineous puncture (SP), and unsuccessful catheter placement (UCP) remain clinically significant. This study aimed to determine their incidence and identify associated predictors.

METHODS This prospective observational study was conducted over one year in a tertiary care centre. Adult patients undergoing epidural catheterization were included. A total of 117 epidural attempts in 100 patients were analysed. Patient- and procedure-related variables were assessed using chi-square test and logistic regression.

RESULTS The incidence of SP, ADP, and UCP was 3.4%, 2.6%, and 8.5%, respectively. UCP was the most frequent complication. Age ≥50 years (p < 0.001) and use of a 16G needle (p = 0.002) were significantly associated with complications.

CONCLUSIONS Immediate complications during epidural catheterization are influenced by patient age and needle size. Use of smaller gauge needles and careful technique in elderly patients may reduce complication rates.

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Published

2026-07-31

How to Cite

Karki, P., Khanal, K., Tiwari, P., Joshi, P., & Acharya, K. (2026). Incidence of Accidental Dural Perforation, Sanguineous Puncture, and Unsuccessful Catheter Placement and Their Predictors During Epidural Catheterization: A Prospective Observational Study. Nepal Mediciti Medical Journal, 7(1), 5-8. https://doi.org/10.3126/nmmj.v7i1.97930

Issue

Vol. 7 No. 1 (2026)

Section

Original Articles

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Copyright (c) 2026 Nepal Mediciti Medical Journal

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How to Cite

Karki, P., Khanal, K., Tiwari, P., Joshi, P., & Acharya, K. (2026). Incidence of Accidental Dural Perforation, Sanguineous Puncture, and Unsuccessful Catheter Placement and Their Predictors During Epidural Catheterization: A Prospective Observational Study. Nepal Mediciti Medical Journal, 7(1), 5-8. https://doi.org/10.3126/nmmj.v7i1.97930