Real-Time Ultrasonography for the Placement of Caudal

A&A practice · Oct 2024

Case Reports

Real-Time Ultrasonography for the Placement of Caudal Epidurals for Thoracic Surgery in Infants: A Description of the Technique and Case Series.

Caudal epidural catheters threaded to the thoracic levels are increasingly utilized in infants undergoing thoracic and abdominal surgery, compared to lumbar or thoracic epidural techniques. Estimating catheter length traditionally relies on anatomical landmarks, but the lack of spine ossification in infants makes ultrasonography a valuable and noninvasive tool. We present 3 cases where real-time ultrasonography facilitated caudal to thoracic epidural catheter placement in infants undergoing thoraco-abdominal surgeries. Incision-congruent placement of the catheter tip ensured effective perioperative analgesia with low doses of bupivacaine administered as intermittent boluses resulting in potent and prolonged analgesia with reduced opioid requirements.

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- Mithun A Varman, Subramanian Vv, Sripriya R, and Kundrapu Asha.
- From the Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
- A A Pract. 2024 Oct 1; 18 (10): e01861e01861.
AbstractCaudal epidural catheters threaded to the thoracic levels are increasingly utilized in infants undergoing thoracic and abdominal surgery, compared to lumbar or thoracic epidural techniques. Estimating catheter length traditionally relies on anatomical landmarks, but the lack of spine ossification in infants makes ultrasonography a valuable and noninvasive tool. We present 3 cases where real-time ultrasonography facilitated caudal to thoracic epidural catheter placement in infants undergoing thoraco-abdominal surgeries. Incision-congruent placement of the catheter tip ensured effective perioperative analgesia with low doses of bupivacaine administered as intermittent boluses resulting in potent and prolonged analgesia with reduced opioid requirements.Copyright © 2024 International Anesthesia Research Society.

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Real-Time Ultrasonography for the Placement of Caudal Epidurals for Thoracic Surgery in Infants: A Description of the Technique and Case Series.

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