P.P. SAFIN

Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, 138 Orenburgskiy Trakt, Kazan, Russian Federation, 420064

 Safin R.R. ― D. Sc. (medicine), Chief Researcher, e-mail: [email protected], ORCID ID: 0000-0003-0960-7424

The catheter insertion in the epidural space in children of younger preschool age should be performed under general anesthesia if serious surgery is planned for the lower extremities. This fact significantly limits the possibility of using the criteria of correct catheter insertion, that relates to adults, based on verbal contact with the patient and description of the nature of the sensations in the lower limbs that accompany the development of the epidural block. Such working conditions increase the percentage of errors and failures, since it is impossible to assess the correctness of the catheter insertion under the visual control. Ultrasound visualization of the vertebral canal and identification of its structures, such as the yellow ligament, epidural and subarachnoid space, makes it possible to reliably and safely install the catheter in the epidural space and monitor its position. At the same time, there is an opportunity to improve the reliability and safety of the epidural anesthesia itself. The article presents a clinical case of successful use of ultrasound imaging in which ultrasound control was used during the catheterization of the epidural space in a child with severe post-burn deformation of the lower limb at the age of 2 years and 10 months in order to ensure full anesthesia during surgery ― excision of the keloid scars that deform the lower limb.

Key words: ultrasound imaging, catheterization of the epidural cavity.

 (For citation: P.P. Safin Application of ultrasound navigation to visualize the epidural space and to identify the correct placement of the catheter in a patient of younger preschool age. Practical Medicine. 2018)

REFERENCES

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2. Voloshin A.G. Four-dimensional ultrasound guidance during epidural J. Ultrasound., 2014, vol. 18, no. 2, pp. 135-142.