Espacio epidural en niños / Pediatric epidural space

Abril 26, 2017. No. 2671

Estimación de la profundidad del espacio epidural torácico en niños utilizando RNM Estimation of the depth of the thoracic epidural space in children using magnetic resonance imaging. Wani TM1, Rafiq M2, Nazir A2, Azzam HA2, Al Zuraigi U2, Tobias JD3. J Pain Res. 2017 Mar 28;10:757-762. doi: 10.2147/JPR.S124123. eCollection 2017. Abstract BACKGROUND: The estimation of the distance from the skin to the thoracic epidural space or skin to epidural depth (SED) may increase the success rate and decrease the incidence of complications during placement of a thoracic epidural catheter. Magnetic resonance imaging (MRI) is the most comprehensive imaging modality of the spine, allowing for the accurate determination of tissue spaces and distances. The present study uses MRI-derived measurements to measure the SED and define the ratio between the straight and inclined SEDs at two thoracic levels (T6-7 and T9-10) in children. METHODS: The T2-weighed sagittal MRI images of 109 children, ranging in age from 1 month to 8 years, undergoing radiological evaluation unrelated to spine pathology were assessed. The SEDs (inclined and straight) were determined, and a comparison between the SEDs at two thoracic levels (T6-7 and T9-10) was made. Univariate and multivariate linear regression models were used to assess the relationship of the inclined thoracic T6-7 and T9-10 SED measurements with age, height, and weight. RESULTS: Body weight demonstrated a stronger association with the SED than did the age or height with R2 values of 0.6 for T6-7 and 0.5 for T9-10. The formulae describing the relationship between the weight and the inclined SED were T6-7 inclined (mm) = 7 + 0.9 × kg and T9-10 inclined (mm) = 7 + 0.8 × kg. CONCLUSION: The depth of the pediatric thoracic epidural space shows a stronger correlation with weight than with age or height. Based on the MRI data, the predictive weight-based formulas can serve as guide to clinicians for placement of thoracic epidural catheters. KEYWORDS: magnetic resonance imaging; measurement techniques; thoracic epidural space PDF Vacante para Anestesiología Pediátrica El Hospital de Especialidades Pediátricas de León, Guanajuato México  ofrece un contrato laboral en el departamento de anestesiología  Informes con la Dra Angélica García Álvarez  angy.coachanestped@gmail.com o al teléfono 477 101 8700 Ext 1028

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org