Replacing the catheter is the thing to do at this point. 

You have just spent fifteen to twenty minutes fiddling with this catheter and the patient is still in pain.

Once you get the needle in the epidural space you can give a bolus of lidocaine thru the needle, which will give the patient another 1 - 2 hours of analgesia for which she will be thankful, in the event that the second catheter goes into an epidural vein again.

By the way that is exactly what happened in this patient, but fortunately I was able to get it out of the vein and confirm that it was not intravascular using epinephrine as described in the other options for this question.

Return to this question     Return to beginning of OB questions     Return to Education Corner