Back to Search
Start Over
Measuring the depth of the caudal epidural space to prevent dural sac puncture during caudal block in children
- Source :
- Paediatric anaesthesia. 27(5)
- Publication Year :
- 2016
-
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.
- Subjects :
- 0301 basic medicine
Epidural Space
Male
medicine.medical_specialty
Body Surface Area
03 medical and health sciences
0302 clinical medicine
Pain control
030202 anesthesiology
Maximum depth
Medicine
Humans
Child
Retrospective Studies
Ligaments
medicine.diagnostic_test
business.industry
Sacrococcygeal Region
Body Weight
Age Factors
Infant
Magnetic resonance imaging
Anatomy
Magnetic Resonance Imaging
Sagittal plane
Body Height
Surgery
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Needles
Child, Preschool
Pediatrics, Perinatology and Child Health
Ligament
Caudal epidural
Female
030101 anatomy & morphology
Dura Mater
business
Sacrococcygeal membrane
Anesthesia, Caudal
Algorithms
Abdominal surgery
Subjects
Details
- ISSN :
- 14609592
- Volume :
- 27
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Paediatric anaesthesia
- Accession number :
- edsair.doi.dedup.....7187eb7384ab91cf1f3a678e3ce02780