• Thomas Strandness, Marisa Wiktor, Jaya Varadarajan, and Steven Weisman.
• Department of Pediatric Anesthesia, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
• Paediatr Anaesth. 2015 Jun 1;25(6):610-3.

BackgroundPostoperative pain control in the pediatric population frequently involves epidural catheters placed intraoperatively. A retrospective review of epidural catheter tip position was conducted by evaluation of routine chest anterior-posterior (A-P) X-rays obtained by the surgical and ICU teams.MethodsOf the 174 pediatric epidural catheters placed during a 1-year period at Children's Hospital of Wisconsin, 59 pediatric patients with chest X-rays demonstrating epidural catheter tip on at least 2 days were reviewed. The change in epidural catheter position was then calculated. The overall reason for discontinuation of epidural analgesia in the larger population was also compiled.ResultsIt was determined that epidural catheters migrated more frequently in patients <10 kg and 10-40 kg, when compared to those >40 kg P < 0.001. The average migration seen on X-ray was 1.1 levels inward in those <40 kg and 0.3 levels inward in those >40 kg. The incidence of catheters discontinued secondary to falling out, or migrating in, was also increased in those patients <40 kg when compared to those >40 kg.ConclusionResults suggest that epidural catheters move inward more frequently and fall out more frequently in patients <40 kg.© 2015 John Wiley & Sons Ltd.

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