• S H Yoo, D H Lee, D E Moon, H K Song, Y Jang, and J B Kim.
• Department of Anaesthesia and Pain Medicine, Soonchunhyang University Hospital Cheonan, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea.
• J. Int. Med. Res. 2012 Jan 1;40(6):2370-80.

ObjectiveClinicians hesitate to perform thoracic paravertebral blockade (TPVB) in children due to the potential high risk of adverse effects. No paediatric anatomical guidelines for TPVB exist. This study aimed to estimate the appropriate depth and distance for safe needle positioning in children.MethodsThe depth (D) from the skin to the paravertebral space and the distance (A) from the spinous process to the needle entry point on the skin were measured using chest computed tomography (CT) in children aged between 1 and 9 years. Correlations between age, gender, weight, height, body mass index (BMI) and each of the anatomical measurements were analysed.ResultsEach measurement correlated significantly with age, weight and height, but not with BMI (n = 373 children). Measurements A and D could be calculated by: A = 13.56 + (0.33 × age [years]) + (0.06 × weight [kg]) + 0.47 × (gender [female = 0, male = 1]); and D = 17.49 - (0.35 × age [years]) + (0.55 × weight [kg]).ConclusionThese anatomical guidelines for TPVB are recommended to help prevent anaesthetic complications such as pneumothorax, when ultrasonography and CT are unavailable.

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