Article Text

Download PDFPDF
Assessment of catheter position using chest CT in adults undergoing erector spinae plane analgesia for rib fractures: a retrospective cohort study
  1. Maylyn Wu1,
  2. Charbel Barrak2,
  3. Patrick Forrest2,
  4. Derek Rizzo2 and
  5. Carlos Eduardo Guerra-Londono2
  1. 1Michigan State University College of Osteopathic Medicine, East Lansing, Michigan, USA
  2. 2Department of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health System, Detroit, Michigan, USA
  1. Correspondence to Dr Carlos Eduardo Guerra-Londono, Department of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health System, Detroit, Michigan, USA; guerra.carloseduardo{at}gmail.com

Abstract

Background Continuous erector spinae plane (ESP) analgesia is a common adjuvant for patients with traumatic rib fracture pain and success relies on the ESP catheter remaining within the correct fascial plane for the duration of its placement. However, knowledge on postplacement position of indwelling ESP catheters is largely absent. We hypothesized that migration of over-the-needle ESP catheters was common and detectable with coincidental postprocedure CT.

Methods In this single-center retrospective cohort study, adults admitted to the surgical intensive care unit for traumatic rib fractures between January 2020 and July 2022 were screened. Those receiving continuous ESP analgesia via indwelling catheter and undergoing subsequent chest CT were included. The primary outcome was the proportion of catheters that migrated outside the ESP. The secondary outcome was the distance between the catheter tip and the nearest transverse process (TP) or fascial plane.

Results 160 medical records were screened for eligibility and 15 patients (18 catheters) met the inclusion criteria. 16 of 18 catheters reviewed were found outside the ESP. Furthermore, catheter position was reported as intramuscular in 14 catheters and subcutaneous in 4 catheters. The median distance between catheter tip and the nearest TP (or the ESP) was 23.20 mm sagittally and 25.05 mm axially.

Conclusions Most ESP catheters were found superficial to the fascial plane in the days following their placement. The median distance between the catheter and the ESP is between 23 and 25 mm. Prospective studies should address catheter migration concerns and propose solutions to this common issue.

  • analgesia
  • Nerve Block
  • Pain Management
  • Diagnostic Techniques and Procedures

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

Statistics from Altmetric.com

Request Permissions

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.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

View Full Text

Footnotes

  • X @carloseguerral

  • Contributors MW: investigation, visualization, writing - original draft, review and editing. CB: conceptualization, investigation, data curation, visualization, writing - original draft, review and editing. PF and DR: investigation, writing - review and editing. CEG-L: conceptualization, methodology, investigation, visualization, writing - review and editing, supervision, project administration. CEG-L is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests PF reports a relationship with Avanos Medical that includes: funding grants. PF reports a relationship with GE Healthcare that includes: consulting or advisory. CEG-L reports funding and travel reimbursement from Edwards Lifesciences Corporation and funding from GE Healthcare for research unrelated to the subject matter. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

  • Provenance and peer review Not commissioned; externally peer reviewed.