"Ropi"-Thorax as a Complication of Landmark-Based Paravertebral Pain Catheter Placement: A Case Report.

Authors

Eileen Hu, Apolonia E Abramowicz, Jeff L Xu

Published in

A&A practice. Volume 20. Issue 10. Pages e02298. Oct 01, 2026. Epub Oct 01, 2026.

Abstract

A 42-year-old female sustained multiple unilateral rib fractures and a hemopneumothorax following a motor vehicle collision. A paravertebral catheter was placed for analgesia; however, extensive subcutaneous emphysema obstructed ultrasound visualization, necessitating landmark‑guided placement. A continuous ropivacaine infusion produced excellent analgesia; however, the patient subsequently developed a pleural effusion. Computed tomography revealed a segment of the catheter migrated into the pleural cavity, resulting in inadvertent intrapleural local anesthetic infusion. This case highlights the limitations of landmark-based paravertebral catheter placement in the setting of distorted anatomy and underscores the need to consider catheter malposition when evaluating unexplained pleural effusions during continuous infusions.

PMID:
42825743
Bibliographic data and abstract were imported from PubMed on 02 Oct 2026.

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