Supply chain issues are leading to a global shortage of epidural catheters according to Alberta Health Services and the Canadian Anesthesiologists’ Society is warning doctors to be prepared.
The president of the Canadian Anesthesiologists’ Society said on Friday she’s hearing from doctors in B.C., Alberta, Saskatchewan and Nova Scotia, where in some cases they may have only a two- or three-day supply of the catheters.
“This is unofficial word, but we are getting it from enough sources that we are getting quite concerned,” said Dr. Dolores McKeen who is also a obstetrical anesthesiologist.
“We are telling our members that they have to be prepared and have alternative strategies in place. But if this turns out to be a true equipment shortage we are in big trouble,” McKeen said.
Often used immediately ahead of childbirth, an epidural is a type of regional anesthetic in which a needle is positioned between the bones of the spine and allows the anesthesiologist to insert a small catheter.
A local anesthetic is injected through the catheter. The anesthetic temporarily stops the spinal nerves from working.
The society has notified Health Canada and is working to determine how widespread the shortage is. It’s also warning doctors to have a back up plan for pain management options.
For obstetrics, there are other options but they would not be considered the gold standard, McKeen said. She said they are often used in high-risk pregnancies and are a way to avoid having to do general anesthesia
“There are strategies we can use, but I would say they are not as safe or as accepted as what epidural labour analgesia would be. I do think they are very critical in terms of patient safety. It’s not just about labour analgesia — it’s all about avoiding general anesthesia in that patient population,” McKeen said.
“We know with COVID-19 there have been supply chain issues with lots of medical devices. But this is one I think has taken anesthesiologists by surprise, and one that we are working very diligently with Health Canada and our obstetric colleagues to mitigate that risk as much as possible,” McKeen said.
The Canadian epidural rate for vaginal deliveries increased slightly from 58.6 per cent in 2016–2017 to 59.3 per cent in 2017–2018 according to the Canadian Institute for Health Information.
Alberta Health Services said supply chain issues are leading to a global shortage of epidural catheters and tubing required for pumps used for epidural infusions.
“AHS is considering safe alterations of practice to ensure patients receive an appropriate alternative and will support the continued availability of supply where no clinically appropriate alternative can be used,” an AHS spokesperson said in a statement on Friday, adding they’re working with vendors to get stock as soon as possible.
The spokesperson said the provincial health authority will work with patients directly to discuss options as required and said no patients have been impacted yet.