Evaluation Of Caudal Epidural Anatomy By Ultrasonography İn Pediatric Patients

Study Overview
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Brief Summary
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Detailed study of ultrasonographic caudal epidural anatomy

Detailed Description
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Caudal epidural block is one of the most common methods to provide analgesia for an infraumbilical surgery in children. Although it can be carried out safely and easily, many complications have been described so far, because of inaccurate needle injections. To perform a successful block, a good caudal epidural anatomic assessment is essential. Ultrasonography is an important tool to perform pediatric regional blocks, including caudal blocks. We believe that caudal epidural ultrasound evaluation can be an important option to decrease complications and to achieve a successful attempt; due to that we will try to describe caudal epidural ultrasound imaging and changes from one month to 84 months.

Official Title
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Evaluation Of Caudal Epidural Anatomy By Ultrasonography İn Pediatric Patients

Conditions
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Anesthesia, Caudal, Anatomy, Ultrasonography, Pediatrics

Intervention / Treatment
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* Diagnostic Test: Caudal Epidural Ultrasonography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pediatric patients who applied for any pediatric surgery from 20 january to 20 july Exclusion Criteria: Premature patients Patients who have any sendromic diagnosis Patients who have any musculoskeletal abnormalities Patients who have any spinal abnormalities

Ages Eligible for Study
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Minimum Age: 1 Month
Maximum Age: 84 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group I<br>Caudal Epidural Ultrasonography will be performed in patients aged between 1-24 months | Diagnostic Test: Caudal Epidural Ultrasonography<br>* Ultrasonographic Measurement<br>|
| Group II<br>Caudal Epidural Ultrasonography will be performed in patients aged between 25-48 months | Diagnostic Test: Caudal Epidural Ultrasonography<br>* Ultrasonographic Measurement<br>|
| Group III<br>Caudal Epidural Ultrasonography will be performed in patients aged between 49-84 months | Diagnostic Test: Caudal Epidural Ultrasonography<br>* Ultrasonographic Measurement<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Definition Of Dural Sac Termination Level By Ultrasonography | After general anesthesia, patient will be placed in lateral decubitus position. First, a 12 MHz lineer ultrasound transducer will be placed transversely to obtain the transverse view of sacral hiatus; in this view we will try to show two sacral cornua, sacrococcygeal ligament, posterior sacral bone and caudal epidural depth. Secondly, transducer will be turned parallel to the midline or paravertebral to obtain longitudinal view; in longitudinal view we will try to obtain the images of sacral vertebral corpuses, caudal epidural area and dural sac. We will try to determine the level of dural sac termination according to a part of vertabral corpus or an intervertebral distance. | 5 minutes | 
| Distance Between Dural Sac Termination Level And Placement Of Caudal Epidural Needle | Distance Between Dural Sac Termination Level And Placement Of Caudal Epidural Needle will be measured under longitudinal ultrasound view | 5 minutes | 
| Definition Of Average Caudal Epidural Depth By Ultrasonography | Definition of caudal epidural depth by ultrasonography will be obtained under transverse view for every patient and average value will be defined for every age group. | 5 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determination Of Sacral Cornua As An Anatomic Landmark And Confirmation By Ultrasonography | Sacral cornua will be palpated and than will be scanned under transverse ultrasound view. Also results will be compared. | 5 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Caudal block, Ultrasound, Children, Regional block anatomy