Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
Journal website https://jmc.elmerpub.com

Case Report

Volume 16, Number 2, February 2025, pages 43-47

Dual Tunneled Epidural Wound Catheters for Postoperative Analgesia Following Posterior Spinal Fusion

Figures

Figure 1.
Figure 1. Photograph of a 19-gauge wound catheter with 60 fenestrations at the distal 150 mm of the catheter and break-away needle used for insertion/skin tunnelling. The fenestrations allow an even spread of the local anesthetic solution along the course of the catheter.
Figure 2.
Figure 2. Postoperative photograph after wound closure. One catheter (red arrow) was threaded cephalad in the epidural space, while the second catheter (blue arrow) was threaded caudally. Both catheters exited the skin to the right of the surgical incision. The surgical site is surrounded by a transparent antimicrobial drape. Anatomic landmarks are labeled.

Table

Table 1. Postoperative Pain Scores and Analgesic Requirements
 
Postoperative dayMedian FLACC scoreMaximum FLACC scoreHydromorphone PCA dosesa
aEach PCA dose included 0.1 mg intravenous hydromorphone. FLACC: Face, Legs, Activity, Cry, and Consolability scale; PCA: patient-controlled analgesia.
0003 (0.3 mg)
1058 (0.8 mg)
2003 (0.3 mg)
3024 (0.4 mg)
4028 (0.8 mg)
5001 (0.1 mg)