Accuracy of the epidural catheter position during the lumbar approach in infants and children: a comparison among L2-3, L3-4, and L4-5 approaches.
10.4097/kjae.2010.58.5.458
- Author:
Yeon A KIM
1
;
Ji Young KIM
;
Hae Keum KIL
;
Eun Mi KIM
;
Mi Kyeong KIM
;
Hye sung KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. toughalex@hotmail.net
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Epidural analgesia;
Pediatrics;
Urologic surgery
- MeSH:
Analgesia, Epidural;
Catheters;
Child;
Fluoroscopy;
Humans;
Incidence;
Infant;
Iohexol;
Pediatrics
- From:Korean Journal of Anesthesiology
2010;58(5):458-463
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The aim of this study was to compare the accuracy of the position of the epidural catheter inserted from three different lumbar intervertebral spaces, L2-3, L3-4, and L4-5, in infants and children. METHODS: Seventy-five children were randomly allocated to 3 groups according to the epidural catheter insertion site (L2-3, L3-4, and L4-5). The epidural catheter tip was identified using 50% diluted Iohexol and fluoroscopy. The incidence of correct position was compared among the groups and between infants and children. RESULTS: The incidence of correct position was significantly higher in the L2-3 group as compared to the L3-4 and L4-5 groups (P = 0.023 and P = 0.046 respectively). The incidence of correct position was higher in infants compared to children (P = 0.017). CONCLUSIONS: The L2-3 intervertebral space is preferable during epidural catheter insertion in children older than 1 year, but a low lumbar level should be considered in infants because they have a higher risk of neural damage.
