Ultrasound-guided paravertebral puncture and placement of catheters in human cadavers: an imaging study

Luyet, C; Eichenberger, U; Greif, R; Vogt, A; Szücs Farkas, Z; Moriggl, B (2009). Ultrasound-guided paravertebral puncture and placement of catheters in human cadavers: an imaging study. British journal of anaesthesia, 102(4), pp. 534-9. Oxford: Oxford University Press 10.1093/bja/aep015

[img]
Preview
Text
aep015.pdf - Published Version
Available under License Publisher holds Copyright.

Download (332kB) | Preview

BACKGROUND: During paravertebral block, the anterolateral limit of the paravertebral space, which consists of the pleura, should preferably not be perforated. Also it is possible that, during the block, the constant superior costotransverse ligament can be missed in the loss-of-resistance technique. We therefore aimed to develop a new technique for an ultrasound-guided puncture of the paravertebral space. METHODS: We performed 20 punctures and catheter placements in 10 human cadavers. A sonographic view showing the pleura and the superior costotransverse ligament was obtained with a slightly oblique scan using a curved array transducer. After inline approach, injection of 10 ml normal saline confirmed the correct position of the needle tip, distended the space, and enabled catheter insertion. The spread of contrast dye injected through the catheters was assessed by CT scans. RESULTS: The superior costotransverse ligament and the paravertebral space were easy to identify. The needle tip reached the paravertebral space without problems under visualization. In contrast, the introduction of the catheter was difficult. The CT scan revealed a correct paravertebral spread of contrast in 11 cases. Out of the remaining, one catheter was found in the pleural space, in six cases there was an epidural, and in two cases there was a prevertebral spread of contrast dye. CONCLUSIONS: We successfully developed a technique for an accurate ultrasound-guided puncture of the paravertebral space. We also showed that when a catheter is introduced through the needle with the tip lying in the paravertebral space, there is a high probability of catheter misplacement into the epidural, mediastinal, or pleural spaces.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Luyet, Cédric; Eichenberger, Urs; Greif, Robert; Vogt, Andreas and Szücs Farkas, Zsolt

ISSN:

0007-0912

ISBN:

19244265

Publisher:

Oxford University Press

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

04 Oct 2013 15:03

Last Modified:

27 Apr 2018 10:29

Publisher DOI:

10.1093/bja/aep015

PubMed ID:

19244265

Web of Science ID:

000264189700015

BORIS DOI:

10.7892/boris.27270

URI:

https://boris.unibe.ch/id/eprint/27270 (FactScience: 105854)

Actions (login required)

Edit item Edit item
Provide Feedback