Retrolaminar Continuous Nerve Block Catheter for Multiple Rib Fractures: A Case Report

Area of Science:

• Pain management
• Regional anesthesia
• Thoracic trauma

Background:

• Rib fractures often lead to severe pain and complications like pneumonia.
• Ultrasound-guided regional anesthesia is standard for rib fracture pain.
• Ultrasound imaging can be unreliable in certain clinical scenarios.

Observation:

• A 67-year-old male with COPD and an intrathecal pump presented with multiple rib fractures.
• Ultrasound guidance was not feasible for regional anesthesia placement.
• A continuous retrolaminar nerve block catheter was placed using a tactile, landmark-based approach.

Findings:

• Successful placement of a continuous retrolaminar nerve block catheter without ultrasound.
• Effective management of unilateral rib fracture pain was achieved.
• The tactile approach provided a viable alternative to ultrasound-guided nerve blocks.

Implications:

• Tactile-guided retrolaminar nerve blocks are a feasible alternative when ultrasound is unavailable.
• This technique can be used in patients with complex comorbidities and prior interventions.
• Landmark-based regional anesthesia can improve pain control in thoracic trauma.