Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2022.03.004
Brazilian Journal of Anesthesiology
Case Report

Real-time ultrasound-guided epidural catheter placement in infants: a case series

Colocação de cateter peridural guiado por ultrassom em tempo real em lactentes: uma série de casos

Manoj Kamal, Mritunjay Kumar, Pooja Bihani, Tanya Mital, Geeta Singariya, Pradeep Bhatia

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Abstract

Although epidural catheter insertion under ultrasound (US) guidance in the pediatric age group has been reported in the literature, it is yet to be adopted widely in clinical practice. The incomplete fusion of bones in pediatric patients provides an acoustic window for the US. The epidural space in children is at shallow depth, hence a high-frequency probe, which provides better resolution can be used. We present a case series in which real-time US-guided epidural catheter placement was performed in 10 infants in lower thoracic and upper lumbar interspaces. We reiterate that the use of real-time US during epidural catheter placement in patients increases the success rate of epidural catheter placement while decreasing procedural complications.

Keywords

Case report; Epidural; Pediatrics; Ultrasound

Resumo

Embora a inserção de cateter peridural sob orientação ultrassonográfica (US) na faixa etária pediátrica tenha sido relatada na literatura, ela ainda precisa ser amplamente adotada na prática clínica. A fusão incompleta dos ossos em pacientes pediátricos fornece uma janela acústica para o US. O espaço peridural em crianças é raso, portanto, uma sonda de alta frequência, que fornece melhor resolução, pode ser usada. Apresentamos uma série de casos em que a colocação de cateter peridural guiado por US em tempo real foi realizada em 10 bebês nos interespaços torácicos inferiores e lombares superiores. Reiteramos que o uso de US em tempo real durante a colocação do cateter peridural em pacientes aumenta a taxa de sucesso da colocação do cateter peridural, ao mesmo tempo que diminui as complicações do procedimento.

Palavras-chave

Relato de caso; Peridural; Pediatria; Ultrassom

References

1. Willschke H, Bosenberg A, Marhofer P, Willscheke J, Schwindt J, Weintraud M, et al. Epidural catheter placement in neonates: Sonoanatomy and feasibility of ultrasonographic guidance in term and preterm neonates. Reg Anesth Pain Med. 2007;32:34 −40.

2. Willschke H, Marhofer P, Bosenberg A, Johnston A, Wanzel O, € Sitzwohl C, et al. Epidural catheter placement in children: comparing a novel approach using ultrasound guidance and a standard loss-of-resistance technique. Br J Anaesth. 2006;97:200−7.

3. Marhofer P, Lonnqvist PA. The use of ultrasound-guided regional € anaesthetic techniques in neonates and young infants. Acta Anaesthesiol Scand. 2014;58(9):1049−60.

4. Walker BJ, et al. Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network. Anesthesiology. 2018 Oct;129 (4):721−32.

5. Wiegele M, Marhofer P, Lonnqvist PA. Caudal epidural blocks in € paediatric patients: a review and practical considerations. Br J Anaesth. 2019;122(4):509−17.


Submitted date:
12/02/2020

Accepted date:
03/08/2022

626fdaeba9539517d55f0b33 rba Articles
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Braz J Anesthesiol

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