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논문 기본 정보

자료유형
학술저널
저자정보
Mital Tanya (All India Institute of Medical Sciences) Kamal Manoj (All India Institute of Medical Sciences) Kumar Mritunjay (All India Institute of Medical Sciences) Kumar Rakesh (All India Institute of Medical Sciences) Bhatia Pradeep (All India Institute of Medical Sciences) Singariya Geeta (Dr S N Medical College)
저널정보
대한마취통증의학회(구 대한마취과학회) Anesthesia and Pain Medicine Anesthesia and Pain Medicine Vol.16 No.4
발행연도
2021.10
수록면
368 - 376 (9page)
DOI
10.17085/apm.21035

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Background: Epidural block placement in pediatric patients is technically challenging for anesthesiologists. The use of ultrasound (US) for the placement of an epidural catheter has shown promise. We compared landmark-guided and US-guided lumbar or lower thoracic epidural needle placement in pediatric patients.Methods: This prospective, randomized, comparative trial involved children aged 1?6 years who underwent abdominal and thoracic surgeries. Forty-five children were randomly divided into two groups using a computer-generated random number table, and group allocation was performed by the sealed opaque method into either landmark-guided (group LT) or real-time ultrasound-guided (group UT) epidural placement. The primary outcome was a comparison of the procedure time (excluding US probe preparation). Secondary outcomes were the number of attempts (re-insertion of the needle), bone contacts, needle redirection, skin-to-epidural distance using the US in both groups, success rate, and complications.Results: The median (interquartile range [IQR]) time to reach epidural space was 105.5 (297.0) seconds in group LT and 143.0 (150) seconds in group UT; P = 0.407). While the first attempt success rate was higher in the UT group (87.0% in UT vs. 40.9% in LT; P = 0.004), the number of bone contacts, needle redirections, and procedure-related complications were significantly lower. Conclusions: The use of US significantly reduced needle redirection, number of attempts, bone contact, and complications. There was no statistically significant difference in the time to access the epidural space between the US and landmark technique groups.

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