Adjunctive Imaging to Confirm Ultrasound-Guided Paravertebral Catheter Tip Position in Children: Case Reports

Paravertebral catheters (PVCs) are frequently used for perioperative analgesia for thoracic procedures in pediatric patients; placement can be challenging even under ultrasound guidance, and misplacement is not unusual. We describe two techniques for confirmation of PVC placement: fluoroscopic and thoracoscopic visualization of the catheter tip. Secondary confirmation of the catheter position allows for removal and prevention of potential complications since these procedures are often performed under general anesthesia and testing the dermatomal coverage of the block on a wake child might not be feasible. These techniques may allow for recognition of an incorrect catheter and prevent potential harm to patients.