• Korean J Anesthesiol · May 2010

    Accuracy of the epidural catheter position during the lumbar approach in infants and children: a comparison among L2-3, L3-4, and L4-5 approaches.

    • Yeon A Kim, Ji Young Kim, Hae Keum Kil, Eun-Mi Kim, Mi Kyeong Kim, and Hye-Sung Kim.
    • Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
    • Korean J Anesthesiol. 2010 May 1;58(5):458-63.

    BackgroundThe aim of this study was to compare the accuracy of the position of the epidural catheter inserted from three different lumbar intervertebral spaces, L2-3, L3-4, and L4-5, in infants and children.MethodsSeventy-five children were randomly allocated to 3 groups according to the epidural catheter insertion site (L2-3, L3-4, and L4-5). The epidural catheter tip was identified using 50% diluted Iohexol and fluoroscopy. The incidence of correct position was compared among the groups and between infants and children.ResultsThe incidence of correct position was significantly higher in the L2-3 group as compared to the L3-4 and L4-5 groups (P = 0.023 and P = 0.046 respectively). The incidence of correct position was higher in infants compared to children (P = 0.017).ConclusionsThe L2-3 intervertebral space is preferable during epidural catheter insertion in children older than 1 year, but a low lumbar level should be considered in infants because they have a higher risk of neural damage.

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