Case Report: Thoracic paravertebral catheter positioning for postoperative continuous analgesia
Year: 2026
Type: article
Study design: Case Report
Abstract: Background The thoracic paravertebral block (PVTB) is a regional anesthesia technique that targets the paravertebral space, providing unilateral, segmental analgesia. This technique is applied in various procedures, including thoracic surgery, and for postoperative pain management in video-assisted thoracic surgery (VATS). The ultrasound-guided technique has gained popularity due to its precision. Despite its benefits, a major limitation is the short duration of its effect, typically lasting no more than 12 h. As a result, continuous PVTB is often preferred but presents challenges in catheter placement and maintenance. Case report This case describes the use of an ultrasound-guided thoracic paravertebral catheter for continuous analgesia in a left VATS pneumonectomy. A 50-year-old patient (BMI of 30 and history of chronic obstructive pulmonary disease) underwent the procedure under general anesthesia. After catheter placement using a SonoLong Echo™ needle, the position was confirmed through hydrodissection and a “bubble test” with saline. Postoperative pain management involved a continuous ropivacaine infusion and rescue doses. The patient experienced effective relief, with numerical rating scale scores consistently below 3, and was discharged on the 8th postoperative day without complications. Conclusion Ultrasound-guided thoracic paravertebral catheter placement offers a reliable alternative to epidural analgesia for thoracic surgeries. Despite concerns about catheter malpositioning, particularly in obese patients, our experience demonstrates that the saline “bubble test” effectively confirms the catheter's position. This approach provides excellent postoperative pain control with minimal complications, making it a valuable technique for managing pain in VATS and other thoracic procedures.
Source: Frontiers in Anesthesiology
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,353
OpenAlex ID: W7164522016