Catheter Tip Position and Contrast Distribution Following Paravertebral Catheter Insertion: a CT Study

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.

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Key information

Conditions

Breast Cancer Patients

Sex eligibility

Female

Study type

Observational

Primary location

Clinique Sainte-Anne Saint Rémi

Brussels, Belgium

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Primary outcomes

Paravertebral catheter tip position

Time frame: 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 outcomes

Paravertebral contrast distribution

Time frame: 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.

Sponsors and collaborators

Lead sponsor

Ziekenhuis Oost-Limburg

Other

Collaborators

Chirec

Registry information

Important dates

Study start: 2010
Primary completion: 2012
Study completion: 2012
First posted: Jul 14, 2025
Registry last updated: Jul 14, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed