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Brief technical report
Success of bedside ultrasound to identify puncture site for spinal anesthesia in neonates and infants
  1. Federico Cristiani1,
  2. Ronnie Henderson1,
  3. Clarisa Lauber1 and
  4. Karen Boretsky2
  1. 1 Department of Anesthesia, Pereira Rossell Hospital, Montevideo, Uruguay
  2. 2 Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Federico Cristiani, Pereira Rossell Hospital, Montevideo 11600, Uruguay; federicocristiani9{at}gmail.com

Abstract

Spinal anesthesia (SA) may be difficult in small infants. Conceptual advantages of ultrasound imaging to view critical neuraxial structures and exploiting the acoustic window unique to infants have been described but not clinically verified. We present 14 preterm-infants aged 35–48 weeks, weighing 1575–5800 g, and describe ultrasound imaging to locate an appropriate puncture site for SA. The success rate for first puncture was 64%, and the overall success on three attempts was 86%. The mean dural depth was 8 mm (1.6). The inferior medullary cone location was just above L3–L4 in 85.7% of patients. Ultrasound imaging for SA in infants may offer advantages.

  • neuraxial blocks: spinal
  • pediatrics
  • ultrasound in pain medicine

https://doi.org/10.1136/rapm-2019-100672

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    Footnotes

    • Presented at Interim data from this work were presented at Society of Pediatric Anesthesia Meeting in Houston, March 16th, 2019.

    • Contributors FC conceived the idea, performed the procedures, discussed the results and wrote the manuscript. RH performed the procedures, discussed the results and wrote the manuscript. CL conceived the idea and performed and supervised the procedures. KB performed and supervised the procedures, performed analytic calculations, and supervised and revised the project. All authors discussed the results and contributed to the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.