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State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Detection of epidural catheters with ultrasound in children
M S Chawathe1, R M Jones, C D Gildersleve
1Department of Anaesthesia, University Hospital of Wales, Heath Park, Cardiff, UK. monica.chawathe@bromor-tr.nhs.uk
Insights
Ultrasound can visualize epidural catheters in children under six months old. This noninvasive imaging technique helps confirm correct placement of epidural analgesia in pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Medical Imaging
- Radiology
Background:
- Epidural analgesia is common in pediatric surgery.
- Accurate placement of epidural catheters is crucial for effective pain management.
- Noninvasive imaging methods for verifying epidural catheter placement in children are needed.
Purpose of the Study:
- To evaluate the feasibility of using ultrasound to visualize epidural catheters in the epidural space in pediatric patients.
- To determine if ultrasound can confirm the position and extent of epidural catheters in children.
Main Methods:
- A pilot study involving 12 pediatric patients requiring epidural analgesia was conducted.
- Ultrasound scans were performed by consultant pediatric radiologists within 24 hours of catheter insertion.
- The primary goal was to identify the catheter within the epidural space and visualize its length.
Main Results:
- Ultrasound successfully detected epidural catheters in 9 out of 12 patients (75%).
- Catheter visualization was achieved in all patients under 6 months of age.
- The entire catheter length was visualized in 5 patients, and the cephalad extent was estimated in 7 patients.
Conclusions:
- Ultrasound is a viable noninvasive imaging technique for visualizing epidural catheters in the epidural space in infants under 6 months.
- This method can assist in confirming appropriate epidural catheter placement in young children.
- Further studies may explore optimizing ultrasound for precise tip localization.
Background:
The aim of this study was to assess whether a noninvasive imaging technique such as ultrasound could visualize an epidural catheter in the epidural space in children.
Methods:
Following local ethics committee approval and informed parental consent a pilot study of 12 cases was performed. Children undergoing major surgery requiring epidural analgesia were recruited. All catheters were introduced via the lumbar region. All children were scanned within 24 h of epidural insertion by consultant paediatric radiologists. If the catheter was identified in the epidural space then an attempt was made to visualize the entire length of the catheter.
Results:
The epidural catheter was detected in nine of 12 patients. All of these were less than 6 months old. The entire length of the catheter was visualized in five of the nine patients. It was possible to estimate the most cephalad level of the catheter in seven of the nine patients. This was in the thoracic region in all cases and an appropriate level for the intended surgical procedure. It was not possible to precisely identify the tip of the catheter as a distinct entity using ultrasound.
Conclusion:
This study shows that it is possible to visualize an epidural catheter in the epidural space in children under 6 months of age using ultrasound.
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