The effect of flexion on the level of termination of the dural sac in paediatric patients.

Full Abstract

SUMMARY: Although the anatomy of the spinal cord and its associated structures have been well defined, the effects of body position relevant to neuraxial blockade have not been elucidated. This study was designed to determine the effect of body position on the end of the dural sac in children. After induction of anaesthesia, ultrasound examination was performed to evaluate the location of the dural sac end in the lateral position with a straight back and knee, and in the lateral position with the knees, legs, and neck flexed. The level of the end of the dural sac was determined in relation to the vertebrae. Our data demonstrate that the dural sac shifts significantly cephalad in the lateral flexed position used for neuraxial blockade (p < 0.001). These results suggest that the safety margin to avoid dural puncture during hiatal or S2-3 approach for caudal block can be increased in younger children.

Author information

Author/s: Koo, B-N (BN); Hong, J-Y (JY); Kim, J E (JE); Kil, H K (HK);

Affiliation: Assistant Professor, Department of Anaesthesiology & Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

Journal and publication information

Publication Type: Journal Article

Journal: Anaesthesia (Anaesthesia), published in England. (Language: eng)

Reference: 2009-Oct; vol 64 (issue 10) : pp 1072-6

Dates: Created 2009/09/08; Completed 2009/10/07;

PMID: 19735397, status: MEDLINE (last retrieval date: 10/7/2009, IMS Date: )

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