The use of ultrasonography in the perioperative management of penetrating chest trauma with indwelling blade
We report on the anaesthetic and postoperative analgesic management of a patient presenting with a single penetrating thoracic injury, with radiological confirmation of a foreign object still present in the thorax. The patient underwent an emergency right posterolateral thoracotomy. We discuss the use of ultrasound for the insertion of a paravertebral catheter for perioperative analgesic management, and its efficacy in the emergency setting. Furthermore, we discuss the use of perioperative focus assessed transthoracic echocardiography, which had a positive impact on our management, although the case highlights the need for further large multi-centre trials.
Keywords: focus assessed transthoracic echocardiography (FATE), paraverterbral block, penetrating thoracic injury, thoracotomy, ultrasound-guided regional anaesthesia