Breast Cancer Patients
Conditions
Keywords
Thoracic paravertebral catheter, Ultrasound-guided paravertebral block, Catheter depth, Breast cancer patient, CT imaging, Catheter tip position, Mobilization, Contrast distribution, Spread
Brief summary
This retrospective study aims to assess the impact of paravertebral catheter insertion depth on the final anatomical position of the catheter tip. Another objective is to characterize the contrast distribution patterns through paravertebral catheters verified to reside within the thoracic paravertebral space.
Detailed description
The effectiveness of a continuous thoracic paravertebral block depends on optimal catheter tip placement and adequate distribution of local anesthetic. This study evaluated the relation between the catheter insertion depth and the final anatomical position of the catheter tip. Additionally, contrast distribution patterns were assessed for catheter tips residing within the thoracic paravertebral space. Ultrasound-guided paravertebral catheters were inserted at multiple catheter insertion depths beyond the needle tip in 31 patients undergoing breast surgery. Post-mobilization computed tomography (CT) imaging was used to determine the catheter tip location. Catheter tips with a confirmed position in the paravertebral space were further analyzed for contrast distribution.
Interventions
None listed
Sponsors
Chirec
Ziekenhuis Oost-Limburg
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* Breast surgery patients who received a paravertebral catheter at Clinique Sainte-Anne Saint Rémi, Brussels, Belgium, between January 2010 and January 2012
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Paravertebral catheter tip position | 1 Day of breast surgery | Postoperatively, patients underwent CT scanning with 0.1 mL of contrast dye (Iomeron, iomeprol, Bracco) to precisely determine the catheter tip position and permit adjustments if needed. Two anesthesiologists independently evaluated the CT images with regards to the insertion level, depth relative to the lamina, and catheter tip location in relation to key anatomical structures. Tip locations were defined as paravertebral or non-paravertebral. Different locations were identified for both the paravertebral and the non-paravertebral spaces. Paravertebral space locations: Anterior paravertebral: Between the anterior and posterior borders of the vertebral corpus. Periforaminal paravertebral: Within 1 cm of the foramen. Posterior paravertebral: From the foramen to the articular process. Non-paravertebral locations: Prevertebral: Anterior to the vertebral body. Intramuscular: Posterior to the lamina within the erector spinae muscles. Epidural and Pleural: Standard anatomical definition. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Paravertebral contrast distribution | 1 Day of breast surgery | Postoperatively, patients received a CT scan with 0.1 mL of contrast dye (Iomeron, iomeprol, Bracco) to evaluate the catheter tip position. Only patients with a catheter in the paravertebral space received a second bolus of 1 mL contrast dye and 9 mL saline 0.9%. Two anesthesiologists independently evaluated the catheter tip position across the different anatomical areas close to the paravertebral space. Additionally, the contrast distribution was assessed in the anteroposterior and craniocaudal direction of catheters with a paravertebral catheter tip position. Paravertebral space locations: Anterior paravertebral: Between the anterior and posterior borders of the vertebral corpus. Posterior paravertebral: From the foramen to the articular process. Non-paravertebral locations: Prevertebral: Anterior to the vertebral body. Intramuscular: Posterior to the lamina within the erector spinae muscles. Epidural, Intercostal and Pleural: Standard anatomical definitions applied. |
Countries
Belgium
Outcome results
None listed