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Applications of intrathecal catheters in children
1Department of Child Health and Anesthesiology, Division of Pediatric Critical Care/Pediatric Anesthesiology, The University of Missouri, Columbia, Missouri 65212, USA.
Insights
Percutaneously placed lumbar intrathecal catheters offer versatile solutions for pediatric patients, enabling anesthesia, pain management, chemotherapy delivery, and cerebrospinal fluid drainage. This review highlights their diverse applications in managing complex pediatric conditions.
Area of Science:
- Neurosurgery
- Pediatric Anesthesiology
- Pediatric Oncology
Background:
- Access to the intrathecal space is crucial for diagnostics, drug administration, and cerebrospinal fluid (CSF) management.
- Intrathecal catheters provide a minimally invasive route for interventions within the spinal canal.
- Pediatric patients present unique challenges for intrathecal access and management.
Observation:
- This report details the use of percutaneously placed lumbar intrathecal catheters in five pediatric patients.
- Applications included intraoperative anesthesia, postoperative analgesia with intrathecal fentanyl, chronic pain control, repeated intrathecal chemotherapy, and CSF drainage post-encephalocele repair.
- The study reviews the indications and applications of intrathecal catheters in pediatric patients.
Findings:
- Lumbar intrathecal catheters demonstrated utility across a spectrum of pediatric neurosurgical and oncological interventions.
- Successful application for anesthesia, analgesia, chemotherapy delivery, and CSF management was observed.
- The technique provided a viable alternative to general anesthesia and facilitated complex treatment regimens.
Implications:
- Intrathecal catheterization represents a valuable tool in the pediatric armamentarium for managing complex neurological and oncological conditions.
- This approach may enhance treatment efficacy and patient comfort in critically ill children.
- Further research into optimizing intrathecal catheter use in pediatric populations is warranted.
Abstract:
Access to the intrathecal space may be required for sampling of cerebrospinal fluid for diagnostic purposes, for the administration of pharmacological agents, or for cerebrospinal fluid (CSF) drainage to lower intracranial pressure. The current report details five children in whom a percutaneously placed lumbar intrathecal catheter was used: (i) to provide intraoperative surgical anaesthesia instead of general anaesthesia (ii); to deliver intrathecal fentanyl to provide postoperative analgesia (iii); to provide chronic pain control during the terminal stages of metastatic malignancy; (iv) to allow repeated doses of intrathecal chemotherapy; and (v) to allow CSF drainage and prevent CSF leakage following frontal encephalocele repair. The indications and applications of intrathecal catheters in the paediatric aged patient are reviewed.