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Application for ESRA Abstract Prizes:Background and Aims We report a case of inadvertent migration of the epidural catheter into the thoracic paravertebral space, which was recognized in unilateral hypesthesia and was confirmed by epidurography and CT scan.Methods A 63-year-old woman, height 151 cm, weight 82 kg and 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 T11–12 interspace through left paramedian approach. After several attempts, loss of resistance was obtained at a depth of 8 cm, and the catheter was inserted 5 cm cephalad. General anesthesia was maintained with propofol and remifentanil 0.1μg/kg/min or less. Prior to skin incision, mixture of 3 ml ropivacaine 0.75%, 100μg fentanyl and 3 mg morphine was administered through the catheter.Results Throughout the operation, her blood pressure and heart rate were stable, and her postoperative pain control was good. But a day after the operation, her hypesthetic dermatomal level was T8–10 on her right side, while no hypesthesia was detected on the left. Epidurography and CT scan with contrast injection through the catheter revealed catheter migration into the right thoracic paravertebral space and enhancement of the same area. It is suspected that the Tuohy needle was advanced beyond the midline. Paramedian approach and deep insertion distance may have contributed to the inadvertent migration into the paravertebral space.Conclusions When performing epidural puncture, we should be aware that accidental migration of epidural catheter into the paravertebral space might occur. Epidurography and CT scan was useful in identifying epidural catheter migration.