Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission
Application for ESRA Abstract Prizes: I apply as a Trainee/Resident/Fellow (no age limit)
Background and Aims The objective of the study was to evaluate the extent of spread of radiocontrast dye in the paravertebral space in human cadaver, depending on the injection method in response to variable analgesic effect noted in clinical conditions.
Methods 34 fresh frozen human cadavers were subjected to bilateral paravertebral space puncture using Tuohy needle at the level of 5th thoracic spine segment under ultrasound guidance. Metylene blue-iopromidum dye contrast was administered directly through Touhy needle, epidural catheter and pig-tail catheter. The spread pattern of injected contrast was then assessed by CT scan and further dissection.
Results The median (range) cephalo-caudad spread of contrast dye was 4 segments (3-8) regardless of the administration method. The median cephalad spread from the injection site was 1 thoracic segment, median caudad spread was 3 segments for Touhy needle, 2 segments for epidural and pig-tail catheter. The mediastinal (prevertebral) spread of dye was less frequent while performing injection through the pig-tail catheter in comparison to Tuohy needle and epidural catheter. The median ([IQR], range) spread to intervertebral foramina was 2(, 0-5) for Tuohy needle, 3(, 0-5) for epidural catheter and 0(, 0-4) for pig-tail catheter and was statistically significant (p=0.001).
Conclusions Ultrasound-guided, saggital oblique approach to the paravertebral space is a reliable way to obtain multi-level spread of radiocontrast solution. Its range is highly variable and does not depend on the method of administration used. Contrast dye does not spread evenly in both directions from the injection site. All above may contribute to inadequate anesthesia in the clinical conditions.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.