[Two cases of epidural anesthesia using ultrasound imaging]

We report two cases of epidural anesthesia in an 11-year-old obese girl (BMI 34.5) using ultrasound imaging by an inexperienced resident. It was useful for performing epidural anesthesia in these difficult cases to observe anatomical structure around epidural space and to measure the angle and distance from the skin to the epidural space. The distances in ultrasound imaging and actual puncture in case 1 were 171 mm and 250 mm, and in case 2 these were 439 mm and 480 mm, respectively. In both cases, epidural puncture was performed smoothly at the first attempt and there was no adverse effect. We conclude that using ultrasound imaging before epidural puncture in obese children is safer and more educational for residents.