{
  "abstract": "Background\n\nUnintentional intrathecal catheter placement is a recognized complication of labor neuraxial analgesia. Although continuous spinal analgesia (CSA) may be used as a management option, prompt recognition, careful catheter management, and close monitoring are required to prevent complications such as severe spinal anesthesia.Case presentation\n\nA 31-year-old primigravida underwent combined spinal-epidural analgesia for labor pain. Intrathecal catheter placement was diagnosed after a test dose was administered based on hypotension, motor weakness, sensory block, and glucose-positive aspirated fluid. The catheter was managed as CSA with fentanyl-based analgesia under strict monitoring. Although frequent breakthrough pain required rescue boluses, the vaginal delivery was achieved uneventfully. The patient developed a post-dural puncture headache that resolved after an epidural blood patch.Conclusions\n\nThis case illustrates the importance of early recognition of inadvertent intrathecal catheter placement and demonstrates that safe labor analgesia can be achieved through conversion to CSA with careful catheter management and close monitoring.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan. hidewatanabe@ks.kyorin-u.ac.jp.",
    "Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan. hidewatanabe@ks.kyorin-u.ac.jp.",
    "Department of Anesthesiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Hidenobu Watanabe",
      "orcid": "0000-0002-6272-7307"
    },
    {
      "affs": [
        2
      ],
      "name": "Choko Kume"
    },
    {
      "affs": [
        2
      ],
      "name": "Arisa Ijuin"
    },
    {
      "affs": [
        2
      ],
      "name": "Yoko Yamashita"
    },
    {
      "affs": [
        2
      ],
      "name": "Masaki Sato"
    },
    {
      "affs": [
        2
      ],
      "name": "Reiko Ohara"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9y03385a6j0cx.bib",
  "cited_by": 0,
  "doi": "10.1186/s40981-026-00869-1",
  "fulltext_url": "https://europepmc.org/articles/PMC13677652",
  "id": "9y03385a6j0cx",
  "issns": [
    "2363-9024"
  ],
  "landing_url": "https://europepmc.org/article/MED/42894088",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC86-88.9"
    ],
    [
      "lcc",
      "RD78.3-87.3"
    ],
    [
      "openalex",
      "2746|Anesthesia and Pain Management"
    ]
  ],
  "openalex": "W7170108650",
  "pdf_url": "https://europepmc.org/articles/PMC13677652?pdf=render",
  "pmcid": "PMC13677652",
  "pmid": "42894088",
  "published": "2026-07-01",
  "publisher": "SpringerOpen",
  "ris": "https://research.draconitic.com/paper/9y03385a6j0cx.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:42Z",
      "native_id": "MED:42894088",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42894088"
    },
    {
      "first_seen": "2026-10-30T13:45:50Z",
      "native_id": "ee6f07f91f9e48e0a97d858512ec9cf0",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s40981-026-00869-1"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Anesthesia and Pain Management",
      "subfield": "surgery"
    }
  ],
  "title": "Early recognition and safe management of unintentional intrathecal placement of an epidural catheter during combined spinal-epidural labor analgesia: a case report in the context of the 2024 OAA guidelines.",
  "title_text": "Early recognition and safe management of unintentional intrathecal placement of an epidural catheter during combined spinal-epidural labor analgesia: a case report in the context of the 2024 OAA guidelines.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:50Z",
  "url": "https://research.draconitic.com/paper/9y03385a6j0cx",
  "venue": "JA clinical reports",
  "versions": []
}