Intrapleural Catheters
The “intrapleural” space refers to the space inside or within the pleural cavity, although the terms “interpleural” (referring to the same space between the visceral and parietal pleurae) and “subpleural” (referring to below the parietal pleura) have also been used to describe the same space. Providing analgesia by infusing medications into the intrapleural space has been used in a variety of cases including but not limited to upper abdominal surgery, thoracic wall trauma, breast surgery, nephrostomy, esophagectomy, and thoracic surgery, in addition to chronic pain conditions such as chronic pancreatitis, complex regional pain syndrome (CRPS), and postherpetic neuralgia. It is a relatively simple technique to learn with a low incidence of complications and few contraindications. It involves placing a catheter into the tissue plane within the chest wall (the intrapleural space) so that infusion of local anesthetic spreads to several intercostal or paravertebral nerves.
