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Application for ESRA Abstract Prizes:Background and Aims We report a case of epidural catheter migration into the thoracic paravertebral space, which was recognized because of unilateral hypesthesia and confirmed by epidurography and computed tomography (CT).Methods A 63-year-old woman (height 151 cm, weight 82 kg, body mass index 36) was scheduled to undergo laparoscopic right partial nephrectomy under general and epidural anesthesia. Epidural puncture was performed in the left lateral position at the T11–12 intervertebral space via a left paramedian approach. After several attempts, loss of resistance occurred at a depth of 8 cm, and the catheter was inserted 5 cm cephalad. General anesthesia was maintained with propofol and remifentanil 0.02–0.1 μg/kg/min. Before skin incision, a mixture of 3 ml ropivacaine 0.75%, 100 μg fentanyl, and 3 mg morphine was administered via the catheter.Results Intraoperative blood pressure and heart rate were stable, and postoperative pain control was good. The day after the operation, however, the T8–10 dermatomal level was hypesthetic on the right side, whereas no hypesthesia was detected on the left. Epidurography and CT with contrast injection through the catheter revealed catheter migration into the right thoracic paravertebral space and enhancement of the same area. We suspect that the Tuohy needle was advanced beyond the midline. The paramedian approach and deep insertion distance may have contributed to the migration into the paravertebral space.Abstract P273 Figure 1Epidurography. The arrow indicates enhancement of right paravertebral spaceAbstract P273 Figure 2Computed tomography (CT). Image on the left indicates catheter migration into the right paravertebral space, and image on the right indicates enhancement of right paravertebral spaceConclusions When performing epidural puncture, we should be aware that epidural catheter migration into the paravertebral space might occur. Epidurography and CT was useful for identifying this migration.