Confirmation of success rate of landmark‐based caudal blockade in children using ultrasound: A prospective analysis
| Autor: | Andrea Gomez-Moraz, Carlos Camelo, Wasin Luckanavanich, Veronique Falciola, Elena Brusseau, Cornelius A Sullivan, David B. Waisel, Elizabeth Eastburn, Karen Boretsky |
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| Rok vydání: | 2020 |
| Předmět: |
Anesthesia
Epidural Epidural Space medicine.medical_specialty medicine.drug_class 03 medical and health sciences Prospective analysis 0302 clinical medicine 030202 anesthesiology 030225 pediatrics medicine Humans Prospective Studies Child Ultrasonography Landmark Local anesthetic business.industry Ultrasound Infant Newborn Infant Objective method Epidural space Surgery Blockade Anesthesiology and Pain Medicine medicine.anatomical_structure Regional anesthesia Child Preschool Pediatrics Perinatology and Child Health business Anesthesia Caudal |
| Zdroj: | Pediatric Anesthesia. 30:671-675 |
| ISSN: | 1460-9592 1155-5645 |
| Popis: | Background Caudal epidural anesthesia is a frequently performed regional anesthesia block in infants and young children. Traditional landmark-based blind needle insertion remains the norm with no immediate, objective method to determine the presence of local anesthetic in the epidural space. Increasingly, ultrasound-imaging is used in pediatric regional anesthesia with demonstrated improvements in block efficacy and efficiency. The value of ultrasound-imaging in confirming success rate of traditional caudal placement is not well defined. Aim To assess the success rate of conventional landmark-based caudal technique using ultrasound-imaging. Methods Prospective observational study of 30 children ages 1 month to 7 years undergoing surgical procedures with consent for caudal blockade. Provider success rate of caudal blockade placed by landmark technique was measured using ultrasound-imaging of needle tip and local anesthetic flow in the epidural space. Results Ultrasound-imaging demonstrated 80% success to correct positioning of the needle tip and local anesthetic in the epidural space. Failure was associated with decreasing experience and presence of anatomic variances. All improperly positioned needles were subsequently successfully positioned using real-time ultrasound-imaging. Mean time for confirmatory ultrasound-imaging (SD; range) was 1 minute (0.3; 1-3). Conclusion The use of ultrasound-imaging can be used to identify proper needle placement in the sacral epidural canal and facilitate subsequent corrected placement. |
| Databáze: | OpenAIRE |
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