Clinical Case Study: Positioning of Thoracic Paravertebral Catheters for Continuous Postoperative Pain Relief
By
Marco Rispoli
Moana Rossella Nespoli
Dario Maria Mattiacci
Domenico Santonastaso
Maria Caterina Pace
Francesco Coppolino
June 12, 2026
Clinical Scorecard: Clinical Case Study: Positioning of Thoracic Paravertebral Catheters for Continuous Postoperative Pain Relief
At a Glance
Category Detail
Condition Postoperative pain management in thoracic surgery Key Mechanisms Ultrasound-guided thoracic paravertebral block (PVTB) for analgesia Target Population Patients undergoing video-assisted thoracic surgery (VATS) Care Setting Intraoperative and postoperative care
Key Highlights
Ultrasound-guided PVTB provides unilateral, segmental analgesia. Continuous PVTB is preferred for prolonged pain relief post-surgery. Saline 'bubble test' effectively confirms catheter positioning. Patient experienced effective pain relief with NRS scores below 3. Technique offers a reliable alternative to epidural analgesia. Guideline-Based Recommendations
Diagnosis
Assess patient history and physical examination for suitability. Management
Utilize ultrasound-guided techniques for catheter placement. Monitoring & Follow-up
Monitor pain levels and adjust analgesia as needed. Risks
Potential for catheter malpositioning, especially in obese patients. Patient & Prescribing Data
50-year-old male with Class I obesity and COPD.
Continuous ropivacaine infusion provided effective postoperative pain control.
Clinical Best Practices
Perform ultrasound-guided catheter placement for accuracy. Use hydrodissection and bubble test to confirm catheter position. Administer local anesthetic bolus to enhance analgesia. Related Resources & Content
