"Ropi"-Thorax as a Complication of Landmark-Based Paravertebral Pain Catheter Placement: A Case Report.
Eileen Hu, Apolonia E Abramowicz, Jeff L Xu
✦ AI-curated · Sources linked
Case in brief
A 42-year-old female with multiple rib fractures and a hemopneumothorax underwent landmark-guided placement of a paravertebral catheter for analgesia due to obstructed ultrasound visualization. Although the continuous ropivacaine infusion provided effective pain relief, the patient later developed a pleural effusion. Imaging revealed that the catheter had migrated into the pleural cavity, leading to intrapleural local anesthetic infusion.
What made this case unusual
The case illustrates the complications arising from landmark-based catheter placement in the presence of distorted anatomy, specifically the migration of the catheter into the pleural cavity.
Diagnostic / clinical pearl
Clinicians should be aware of the potential for catheter malposition when evaluating unexplained pleural effusions in patients receiving continuous local anesthetic infusions.
Why it matters
This case emphasizes the importance of considering anatomical distortions and the limitations of landmark-based techniques in catheter placement, which can lead to significant complications.