Migration of pediatric epidural catheters. Paediatr Anaesth 2015 Jun;25(6):610-3
Date
01/23/2015Pubmed ID
25611612DOI
10.1111/pan.12579Scopus ID
2-s2.0-84928583175 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
BACKGROUND: Postoperative 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.
METHODS: Of 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.
RESULTS: It 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.
CONCLUSION: Results suggest that epidural catheters move inward more frequently and fall out more frequently in patients <40 kg.
Author List
Strandness T, Wiktor M, Varadarajan J, Weisman SAuthors
Jaya L. Varadarajan MD Associate Professor in the Anesthesiology department at Medical College of WisconsinSteven J. Weisman MD Professor in the Anesthesiology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAge Factors
Analgesia, Epidural
Anesthesia, Epidural
Catheters
Child, Preschool
Epidural Space
Female
Humans
Infant
Male
Radiography
Retrospective Studies
