Paravertebral block catheter breakage by electrocautery during thoracic surgery

Area of Science:

• Anesthesiology
• Surgical Innovation
• Medical Device Engineering

Background:

• Thoracic paravertebral analgesia (TPA) offers advantages for thoracic surgery pain management.
• Catheter placement near the surgical field can lead to intraoperative damage.
• Electrocautery use during surgery poses a risk to TPA catheters.

Observation:

• A case of intraoperative TPA catheter occlusion, cutting, and fusion occurred.
• Electrocautery-induced damage was investigated in three types of epidural catheters.
• Catheters were tested by penetration and cutting with electrocautery on chicken meat.

Findings:

• Standard and radiopaque catheters experienced high rates of breakage and occlusion.
• Reinforced catheters demonstrated significantly lower breakage and no occlusion.
• Some reinforced catheters showed thermal damage at the tip due to electric arcs.

Implications:

• Reinforced catheters may offer improved durability during thoracic surgery.
• Consideration of catheter insertion timing (median approach or post-surgery) is recommended.
• Further research into catheter material and design for electrocautery resistance is warranted.