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

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

References

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

2 H Willschke, P Marhofer, A Bösenberg, A Johnston, O Wanzel, C Sitzwohl, et al. Epidural catheter placement in children: comparing a novel approach using ultrasound guidance and a standard loss-of-resistance technique Br J Anaesth, 97 (2006), pp. 200-207

3 P Marhofer, PA. Lönnqvist The use of ultrasound-guided regional anaesthetic techniques in neonates and young infants Acta Anaesthesiol Scand, 58 (9) (2014), pp. 1049-1060

4 BJ Walker, et al. Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network Anesthesiology, 129 (4) (2018 Oct), pp. 721-732

5 M Wiegele, P Marhofer, PA. Lönnqvist Caudal epidural blocks in paediatric patients: a review and practical considerations Br J Anaesth, 122 (4) (2019), pp. 509-517

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