Adjunctive Imaging to Confirm Ultrasound-Guided Paravertebral Catheter Tip Position in Children: Case Reports.
Renata M Drummond, Farrukh Munshey, Brendan E Morgan
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Case in brief
The report describes children receiving ultrasound-guided paravertebral catheters for perioperative analgesia during thoracic procedures. Because ultrasound-guided placement can be challenging and catheter misplacement may occur, the authors used fluoroscopic or thoracoscopic visualization to confirm catheter-tip position. This secondary check can identify an incorrectly positioned catheter when the procedure is performed under general anesthesia and assessment of dermatomal block coverage in an awake child is not feasible. Recognition of malposition allows catheter removal and may help prevent potential complications.
What made this case unusual
Catheter-tip position was confirmed using fluoroscopy or thoracoscopy, providing a secondary check beyond ultrasound guidance.
Diagnostic / clinical pearl
Ultrasound guidance does not ensure correct paravertebral catheter placement; consider how tip position can be confirmed when clinical assessment of block coverage is not feasible under general anesthesia.
Why it matters
Recognizing malposition may allow catheter removal and help prevent potential patient harm.