0 66

Cited 2 times in

Measuring the depth of the caudal epidural space to prevent dural sac puncture during caudal block in children

Authors
 Hyun Jeong Lee  ;  Ji Young Min  ;  Hyun Il Kim  ;  Hyo‐Jin Byon 
Citation
 Pediatric Anesthesia, Vol.27(5) : 540-544, 2017 
Journal Title
 Pediatric Anesthesia 
ISSN
 1155-5645 
Issue Date
2017
MeSH
Age Factors ; Algorithms* ; Anesthesia, Caudal/adverse effects* ; Anesthesia, Caudal/methods* ; Body Height ; Body Surface Area ; Body Weight ; Child ; Child, Preschool ; Dura Mater/injuries* ; Epidural Space/anatomy & histology* ; Epidural Space/diagnostic imaging* ; Epidural Space/growth & development ; Female ; Humans ; Infant ; Ligaments/anatomy & histology ; Ligaments/diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Needles ; Retrospective Studies ; Sacrococcygeal Region/anatomy & histology ; Sacrococcygeal Region/diagnostic imaging
Keywords
anesthesia, caudal ; anesthesia, regional ; child ; epidural space ; magnetic resonance imaging ; needles
Abstract
BACKGROUND: Caudal blocks are performed through the sacral hiatus in order to provide pain control in children undergoing lower abdominal surgery. During the block, it is important to avoid advancing the needle beyond the sacrococcygeal ligament too much to prevent unintended dural puncture. This study used demographic data to establish simple guidelines for predicting a safe needle depth in the caudal epidural space in children. METHODS: A total of 141 children under 12 years old who had undergone lumbar-sacral magnetic resonance imaging were included. The T2 sagittal image that provided the best view of the sacrococcygeal membrane and the dural sac was chosen. We used Picture Achieving and Communication System (Centricity® PACS, GE Healthcare Co.) to measure the distance between the sacrococcygeal ligament and the dural sac, the length of the sacrococcygeal ligament, and the maximum depth of the caudal space. RESULTS: There were strong correlations between age, weight, height, and BSA, and the distance between the sacrococcygeal ligament and dural sac, as well as the length of the sacrococcygeal ligament. Based on these findings, a simple formula to calculate the distance between the sacrococcygeal ligament and dural sac was developed: 25 × BSA (mm). CONCLUSION: This simple formula can accurately calculate the safe depth of the caudal epidural space to prevent unintended dural puncture during caudal block in children. However, further clinical studies based on this formula are needed to substantiate its utility.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1111/pan.13083
DOI
10.1111/pan.13083
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
김현일(Kim, Hyun IL)
민지영(Min, Ji Young)
변효진(Byon, Hyo Jin)
이현정(Lee, Hyun Jeong)
Export
RIS (EndNote)
XLS (Excel)
XML
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160687
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse