Related Experiment Video
Updated: Oct 9, 2026
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
[Usefulness of radiologic monitoring of epidural catheters using epidurography]
A Díez Rodríguez-Labajo1, F Reinoso-Barbero, P Sanabria
1Servicio de Anestesia y Reanimación, Hospital Infantil, Ciudad Sanitaria La Paz, Madrid.
Insights
Epidurography effectively confirms epidural catheter placement in children, ensuring accurate positioning for postoperative pain management. This imaging technique enhances safety and efficacy in pediatric epidural analgesia.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Radiology
Background:
- Peridural analgesia facilitates pulmonary recovery post-surgery.
- Pediatric epidural catheterization presents anatomical and technical challenges.
Purpose of the Study:
- To evaluate epidurography for radiologic monitoring of epidural catheter placement in pediatric patients.
- To assess the safety and efficacy of epidurography in guiding pediatric epidural analgesia.
Main Methods:
- Eighteen children (2-12 years) received general and epidural anesthesia.
- Contrast injection followed by thoracic or lumbar spinal X-rays confirmed catheter placement.
- Postoperative analgesia utilized bupivacaine and fentanyl via epidural infusion.
Main Results:
- Epidurography confirmed correct catheter tip placement in 17 of 18 cases.
- Linear catheter trajectory was observed in 17 cases; no looping occurred.
- One instance of paravertebral contrast extravasation noted, with no complications from the contrast medium.
Conclusions:
- Epidurography offers objective visualization of epidural catheter tip position and trajectory.
- The technique enhances the safety and accuracy of pediatric epidural catheter placement.
- Increased utilization of epidurography is recommended for pediatric epidural analgesia.
Introduction:
Peridural analgesia involves a segmental block which at the thoracic level allows for early pulmonary recovery after chest or high abdominal surgery. The approach is difficult in children for reasons related to anatomy, maintenance, insertion of the catheter and dosing.
Objective:
To report the radiologic monitoring of epidural catheter placement by epidurography as a technique for placing the epidural catheter in 17 patients for whom postoperative analgesia was to be provided by the same route.
Patients And Methods:
Eighteen children (aged from 2 to 12) were given general anesthesia followed by epidural anesthesia. After catheterization of the epidural space, 1 or 1-5 ml of contrast was injected. Immediately afterwards an X-ray of the thoracic or lumbar spinal column, as appropriate to each case, was obtained. Epidural analgesia was provided with a mixture of bupivacaine 0.125% and fentanyl, in continuous perfusion or in fractionated doses.
Results:
Placement of the catheter tip was confirmed in 17 cases by visualization of symmetry and the presence of contrast medium in the epidural space. In one case we observed extravasation of contrast medium, which had invaded the paravertebral space. The course was linear in 17 cases, with no looping. No complications related to injection of contrast medium were observed.
Conclusions:
Epidurography provides objective monitoring of tip placement and trajectory of epidural catheters, advantages which argue in favor of more frequent application of this imaging technique.
Related Concept Videos
01:26Cardiac Catheterization IV: Nursing Management
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
01:19Imaging Studies VII: Vascular Imaging