{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:16:38Z","timestamp":1788444998252,"version":"build-2803163510"},"reference-count":27,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2024,6,23]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Continuous erector spinae plane (ESP) analgesia is a common adjuvant for patients with traumatic rib fracture pain and success relies on the ESP catheter remaining within the correct fascial plane for the duration of its placement. However, knowledge on postplacement position of indwelling ESP catheters is largely absent. We hypothesized that migration of over-the-needle ESP catheters was common and detectable with coincidental postprocedure CT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this single-center retrospective cohort study, adults admitted to the surgical intensive care unit for traumatic rib fractures between January 2020 and July 2022 were screened. Those receiving continuous ESP analgesia via indwelling catheter and undergoing subsequent chest CT were included. The primary outcome was the proportion of catheters that migrated outside the ESP. The secondary outcome was the distance between the catheter tip and the nearest transverse process (TP) or fascial plane.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>160 medical records were screened for eligibility and 15\u2009patients (18 catheters) met the inclusion criteria. 16 of 18 catheters reviewed were found outside the ESP. Furthermore, catheter position was reported as intramuscular in 14 catheters and subcutaneous in 4 catheters. The median distance between catheter tip and the nearest TP (or the ESP) was 23.20\u2009mm sagittally and 25.05\u2009mm axially.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Most ESP catheters were found superficial to the fascial plane in the days following their placement. The median distance between the catheter and the ESP is between 23 and 25\u2009mm. Prospective studies should address catheter migration concerns and propose solutions to this common issue.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2024-105673","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T15:20:12Z","timestamp":1720192812000},"page":"779-785","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Assessment of catheter position using chest CT in adults undergoing erector spinae plane analgesia for rib fractures: a retrospective cohort study"],"prefix":"10.1136","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1765-3625","authenticated-orcid":false,"given":"Maylyn","family":"Wu","sequence":"first","affiliation":[{"name":"Michigan State University College of Osteopathic Medicine, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charbel","family":"Barrak","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health System, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Forrest","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health System, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health System, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5227-6047","authenticated-orcid":false,"given":"Carlos Eduardo","family":"Guerra-Londono","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health System, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"key":"2025101113352769000_50.10.779.1","doi-asserted-by":"crossref","first-page":"2953","DOI":"10.1016\/j.injury.2022.03.058","article-title":"Management and outcomes of rib fractures in patients with isolated blunt thoracic trauma: results of the Aotearoa New Zealand Ribz study","volume":"53","author":"McGuinness","year":"2022","journal-title":"Injury"},{"key":"2025101113352769000_50.10.779.2","doi-asserted-by":"crossref","unstructured":"McGuinness MJ , Isles S , Xu W , et al . Incidence and outcomes of major trauma patients with thoracic injuries and rib fractures in Aotearoa New Zealand. Injury 2023;54. doi:10.1016\/j.injury.2023.05.018","DOI":"10.1016\/j.injury.2023.05.018"},{"key":"2025101113352769000_50.10.779.3","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.jss.2022.04.001","article-title":"Admission triage with pain, inspiratory effort, cough score can predict critical care utilization and length of stay in isolated chest wall injury","volume":"277","author":"Bass","year":"2022","journal-title":"J Surg Res"},{"key":"2025101113352769000_50.10.779.4","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1097\/TA.0000000000002480","article-title":"The sequential clinical assessment of respiratory function (scarf) score: a dynamic pulmonary physiologic score that predicts adverse outcomes in critically ill rib fracture patients","volume":"87","author":"Hardin","year":"2019","journal-title":"J Trauma Acute Care Surg"},{"key":"2025101113352769000_50.10.779.5","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1111\/anae.14579","article-title":"The effect of erector spinae plane block on respiratory and analgesic outcomes in multiple rib fractures: a retrospective cohort study","volume":"74","author":"Adhikary","year":"2019","journal-title":"Anaesthesia"},{"key":"2025101113352769000_50.10.779.6","first-page":"483","article-title":"Comparison of thoracic erector spinae plane block with thoracic paravertebral block for pain management in patients with unilateral multiple fractured ribs","volume":"25","author":"Elawamy","year":"2022","journal-title":"Pain Physician"},{"key":"2025101113352769000_50.10.779.7","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1177\/00031348221091956","article-title":"Erector spinae plane blocks for traumatic rib fractures: a prospective, interventional study","volume":"88","author":"Palachick","year":"2022","journal-title":"Am Surg"},{"key":"2025101113352769000_50.10.779.8","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1213\/ANE.0000000000005730","article-title":"Safety of continuous erector spinae catheters in chest trauma: a retrospective cohort study","volume":"133","author":"White","year":"2021","journal-title":"Anesth Analg"},{"key":"2025101113352769000_50.10.779.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2018.09.036"},{"key":"2025101113352769000_50.10.779.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"2025101113352769000_50.10.779.11","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000451"},{"key":"2025101113352769000_50.10.779.12","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew172"},{"key":"2025101113352769000_50.10.779.13","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2022-104303"},{"key":"2025101113352769000_50.10.779.14","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4097\/kja.21227","article-title":"Distance of catheter tip dislocation in continuous interscalene brachial plexus block","volume":"75","author":"Abe","year":"2022","journal-title":"Korean J Anesthesiol"},{"key":"2025101113352769000_50.10.779.15","doi-asserted-by":"crossref","unstructured":"Schwenk ES , Gandhi K , Baratta JL , et al . Ultrasound-guided out-of-plane vs. in-plane interscalene catheters: a randomized, prospective study. Anesth Pain Med 2015;5. doi:10.5812\/aapm.31111","DOI":"10.5812\/aapm.31111"},{"key":"2025101113352769000_50.10.779.16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s00540-020-02888-3","article-title":"Incidence and effects of postoperative migration of interscalene catheter tips placed using ultrasound-guided anterior and posterior approaches","volume":"35","author":"Aoyama","year":"2021","journal-title":"J Anesth"},{"key":"2025101113352769000_50.10.779.17","doi-asserted-by":"crossref","DOI":"10.1186\/s12871-021-01554-9","article-title":"Reduction of leakage from insertion site during continuous femoral nerve block with catheter-through-needle versus catheter-over-needle technique for postoperative analgesia after total knee arthroplasty: a randomized controlled trial","volume":"22","author":"Hattammaru","year":"2022","journal-title":"BMC Anesth"},{"key":"2025101113352769000_50.10.779.18","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-012-9713-9"},{"key":"2025101113352769000_50.10.779.19","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1053\/j.jvca.2020.11.060","article-title":"Comparison of postoperative pain from catheter over the needle (con) versus catheter through needle (ctn) techniques for erector spinae plane blockade in patients undergoing open heart surgery: a single-center retrospective review","volume":"35","author":"Pfaff","year":"2021","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2025101113352769000_50.10.779.20","doi-asserted-by":"crossref","first-page":"72","DOI":"10.4097\/kjae.2017.70.1.72","article-title":"Randomized comparison of popliteal-sciatic perineural catheter tip migration and dislocation in a cadaver model using two catheter designs","volume":"70","author":"Steffel","year":"2017","journal-title":"Korean J Anesthesiol"},{"key":"2025101113352769000_50.10.779.21","doi-asserted-by":"crossref","unstructured":"Kim HY , Ahn J-S , Park S , et al . Comparison of catheter-over-needle and catheter-through-needle methods in ultrasound-guided continuous femoral nerve block: a prospective. Medicine (Balt) 2021;100. doi:10.1097\/MD.0000000000026519","DOI":"10.1097\/MD.0000000000026519"},{"key":"2025101113352769000_50.10.779.22","doi-asserted-by":"crossref","first-page":"111072","DOI":"10.1016\/j.jclinane.2023.111072","article-title":"Efficacy of erector spinae plane block for minimally invasive mitral valve surgery: results of a double-blind, prospective randomized placebo-controlled trial","volume":"86","author":"Hoogma","year":"2023","journal-title":"J Clin Anesth"},{"key":"2025101113352769000_50.10.779.23","doi-asserted-by":"crossref","first-page":"111088","DOI":"10.1016\/j.jclinane.2023.111088","article-title":"Erector spinae plane block for postoperative analgesia in robotically-assisted coronary artery bypass surgery: results of a randomized placebo-controlled trial","volume":"87","author":"Hoogma","year":"2023","journal-title":"J Clin Anesth"},{"key":"2025101113352769000_50.10.779.24","doi-asserted-by":"crossref","unstructured":"Eloy A , Tinoco J , Regufe R , et al . Epidural catheter migration: a case report of a ct scan examination. Cureus 2022;14. doi:10.7759\/cureus.30831","DOI":"10.7759\/cureus.30831"},{"key":"2025101113352769000_50.10.779.25","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000313"},{"key":"2025101113352769000_50.10.779.26","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181ca4e5d"},{"key":"2025101113352769000_50.10.779.27","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-101019"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2024-105673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T20:35:34Z","timestamp":1760214934000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2024-105673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,5]]},"references-count":27,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,6]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/rapm-2024-105673"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2024-105673","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,5]]}}}