Placement of coiled catheters into the paravertebral space.
There are conflicting results with regard to the use of catheter-based techniques for continuous paravertebral block. Local anaesthetic spread within the paravertebral space is limited and the clinical effect is often variable. Discrepancies between needle tip position and final catheter position can also be problematic. The aim of this proof-of-concept study was to assess the reliability of placing a newly developed coiled catheter in human cadavers. Sixty Tuohy needles and coiled catheters were placed under ultrasound guidance, three on each side of the thoracic vertebral column in 10 human cadavers. Computed tomography was used to assess needle tip and catheter tip locations. No catheter was misplaced into the epidural, pleural or prevertebral spaces. The mean (SD) distance between catheter tips and needle tips was 8.2 (4.9) mm. The median (IQR [range]) caudo-cephalad spread of contrast dye injectate through a subset of 20 catheters was 4 (4-5[3-8]) thoracic segments. All catheters were removed without incident. Precise paravertebral catheter placement can be achieved using ultrasound-guided placement of a coiled catheter.
University Department of Anaesthesiology and Pain Therapy, University Hospital and University of Bern, Bern, Switzerland. cedric.luyet@insel.ch
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Luyet
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Meyer
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Herrmann
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Hatch
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Ross
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Eichenberger
D002404:Catheterization / Q000379:methods; D057785:Catheters; D006801:Humans; D009407:Nerve Block / Q000295:instrumentation* / Q000379:methods; D013131:Spine / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional