• Seokyung Shin, Ji Young Kim, Won Oak Kim, Seung Hyun Kim, and Hae Keum Kil.
• Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
• Ultrasound Med Biol. 2014 Nov 1;40(11):2630-6.

AbstractThis study assessed ultrasound visibility of spinal structures in children and observed the extent of local anesthetic spread within the epidural space during caudal block. Spinal structures were evaluated with ultrasound from the sacral area to the thoracic area in 80 children, and drug spread levels were observed after caudal injection of 0.5, 1.0, 1.25 and 1.5 mL/kg local anesthetic. The conus medullaris, dural sac and dura mater were easily identified with ultrasound in most children. However, ligamentum flavum visibility declined with increasing vertebral level and markedly decreased at the thoracic level in children older than 7 mo or heavier than 8.5 kg. Drug spread was higher with increasing volume (p < 0.001) and in children ≤12 mo more than children >12 mo (p < 0.001); drug spread was significantly correlated with age (R(2) = 0.534). Spread levels assessed with ultrasound were roughly two to three segments lower than those in previous radiologic studies.Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

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