The Migration of Caudally Threaded Thoracic Epidural Catheters in Neonates and Infants

Anesthesia and Analgesia
Allan F SimpaoThienkim V Ngo

Abstract

The migration of pediatric thoracic epidural catheters via a thoracic insertion site has been described. We assessed the migration of caudally threaded thoracic epidural catheters in neonates and infants at our institution. The anesthesia records and diagnostic imaging studies of neonates and infants who had caudal epidural catheters placed during a 26-month period at our hospital were analyzed. Imaging studies were reviewed for changes in epidural catheter tip position. Eighty-five patients 1-325 days of age (median, 51 days; interquartile range, 39-78 days) and weights of 2.5-9.5 kg (median, 5 kg; interquartile range, 4.3-5.8 kg) met the study criteria. Fifty-four (64%) of the patients (95% CI, 52%-73%) experienced catheter migration of 1 or more vertebral levels (range, 3 levels caudad [outward] to 3 levels cephalad [inward]), and 23 (27%) of the patients (95% CI, 18%-38%) experienced catheter migration to the T4 level or higher. Migration of 2 or more vertebral levels occurred only in children who weighed <6 kg and were under 73 days of age. Epidural catheter migration occurs commonly in neonates and infants. Postoperative imaging is crucial to confirm catheter tip location after epidural catheter placement, as failure to a...Continue Reading

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Citations

Jan 19, 2019·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Adam C AdlerArvind Chandrakantan
Dec 19, 2018·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Alina Lazar, Magdalena Anitescu

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