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Pediatric Anesthesia
Article . 2018 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
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Determining the extent of the dural sac for the performance of caudal epidural blocks in newborns

Authors: Albert‐Neels van Schoor; Marius C. Bosman; Gerda Venter; Adrian T. Bösenberg;

Determining the extent of the dural sac for the performance of caudal epidural blocks in newborns

Abstract

SummaryBackgroundInformation regarding the position and relationship of vital structures within the caudal canal is important for anesthesiologists who perform a caudal block. This information can be acquired by anatomical dissection, with ultrasound technology, or radiological studies.AimsThe aim of this study was to determine the position of the dural sac in neonates by measuring the distance of the termination of the dural sac from the apex of the sacral hiatus in neonatal cadavers.MethodsAfter careful dissection, the distance from the apex of the sacral hiatus to the dural sac was measured in a sample of neonatal cadavers.ResultsIn 39 neonatal cadavers, the mean distance from the apex of the sacral hiatus to the dural sac was 10.45 mm. The range of this distance was between 4.94 and 26.28 mm. The mean distance for females was 9.64 mm (range from 6.66 to 15.09); that for males was 10.90 mm (range between 4.94 and 26.28). Linear regression with the log of this distance as the outcome variable gave an estimated 3.3% increase in the distance for each 1 cm increase in the length of the neonate (95% CI for this proportion was 1.91‐4.71).ConclusionAnesthesiologists should be aware of the short distance between the sacral hiatus and the dural sac when performing caudal blocks, the shortest distance was 4.94 mm. Armed with this knowledge, caudal techniques should be modified to improve the safety and reduce the risk of complications, such as dural puncture.

Country
South Africa
Keywords

Health sciences articles SDG-03, Epidural Space, Male, Risk, Dural sac, SDG-03: Good health and well-being, Sacrum, Lumbar Vertebrae, Infant, Newborn, Lumbosacral Region, 610, Sacral canal, Caudal canal, Caudal epidural anesthesia, Humans, Dura mater, Female, Anatomy, Anesthesia, Caudal

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    popularity
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    Top 10%
    influence
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Top 10%
Average
Average
bronze