Presented in part at the Annual Meeting of the European Society of Regional Anaesthesia, Bordeaux, France, September 2012 and at the Swiss Society of Anaesthesia and Reanimation Annual Meeting, Lausanne, Switzerland, November 2012.
The location of paravertebral catheters placed using the landmark technique
Article first published online: 7 NOV 2012
Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland
Volume 67, Issue 12, pages 1321–1326, December 2012
How to Cite
Luyet, C., Siegenthaler, A., Szucs-Farkas, Z., Hummel, G., Eichenberger, U. and Vogt, A. (2012), The location of paravertebral catheters placed using the landmark technique. Anaesthesia, 67: 1321–1326. doi: 10.1111/j.1365-2044.2012.07234.x
This article is accompanied by an Editorial. See p. 1317 of this issue.
- Issue published online: 7 NOV 2012
- Article first published online: 7 NOV 2012
- Accepted 22 May 2012
The aim of this prospective clinical study was to evaluate the location of paravertebral catheters that were placed using the classical landmark puncture technique and to correlate the distribution of contrast dye injected through the catheters with the extent of somatic block. Paravertebral catheter placement was attempted in 31 patients after video-assisted thoracic surgery. In one patient, an ultrasound-guided approach was chosen after failed catheter placement using the landmark method. A fluoroscopic examination in two planes using contrast dye was followed by injection of local anaesthetic and subsequent clinical testing of the extent of the anaesthetised area. In nine patients (29%), spread of contrast dye was not seen within the paravertebral space as intended. Misplaced catheters were in the epidural space (three patients), in the erector spinae musculature (five patients), and in the pleural space (one patient). There was also a discrepancy between the radiological findings and the observed distribution of loss of sensation. We have demonstrated an unacceptably high misplacement rate of paravertebral catheters using the landmark method. Additional research is required to compare the efficacy and safety of continuous paravertebral block using ultrasound-guided techniques or surgical inserted catheters.