ArticleJournal of anesthesia2012
The caudal space in fetuses: an anatomical study.
Article in Journal of anesthesia, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Evaluated anatomical variations in children by sacrococcygeal ultrasonography as a new tool: a report from a Chinese tertiary hospital.Annals of medicine · 2025Article
- Assessing Caudal Epidural Anatomy in Children: A Comparison of Palpation and Ultrasound for Sacral Cornua Identification.Turkish journal of anaesthesiology and reanimation · 2025Article
- Article
- Ultrasound versus anatomical landmarks for caudal epidural anesthesia in pediatric patients.BMC anesthesiology · 2015Observational
- Where is the apex of the sacral hiatus for caudal epidural block in the pediatric population? A radio-anatomic study.Journal of anesthesia · 2014Article
- Morphologic diversities of sacral canal in children; three-dimensional computed tomographic study.The Korean journal of pain · 2014Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe caudal epidural space is a popular site for analgesia in pediatrics. High variation in blind needle placement is common during caudal epidurals, increasing the risk of intravascular and intrathecal spread. Knowledge of safe distances and angles for accessing the caudal epidural space in premature infants can improve the safety of caudal epidural blocks.
methodsThirty-nine fetuses with crown-heel length between 33 and 50 cm, corresponding to gestational age of 7-9 months, were included. The dorsal surface of the sacrum from the fourth lumbar vertebra to the tip of the coccyx was dissected, following which measurements were taken on dorsal surface and midsagittal sections. The angle of depression of the needle was measured using a goniometer following the two-step method of needle insertion.
resultsRight and left sacral cornua were palpable in 23 of 39 fetuses (58.97%). Termination of dural sac was at S2 in most of the fetuses (53.84%), whereas the apex of the sacral hiatus was at S3 in most (58.97%). The distance from the apex of the hiatus to the termination of dura ranged from 3 to 13 mm; the anteroposterior distance of the canal at the apex of the hiatus ranged from 1.72 to 4.38 mm. All sacral parameters correlated with crown-heel length except inter-cornual distance, depth of canal at hiatus, and height of sacral hiatus.
conclusionDistances and angles for accessing the caudal epidural space in fetuses do not provide all parameters for safe performance of caudal epidural blocks in premature and low birth weight infants because the apex of the sacral hiatus and the termination of the dura show wide variation in location.
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