Evidence map›Paper›PMID 26169595›Full record

Observational studyBMC anesthesiology2015

Ultrasound versus anatomical landmarks for caudal epidural anesthesia in pediatric patients.

Yukako Abukawa, Koichi Hiroki, Nobutada Morioka, Hiroko Iwakiri, Tomoko Fukada, Hideyuki Higuchi, Makoto Ozaki

Open access · goldAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC anesthesiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 24 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Article
  5. Establishment of Difficult Caudal Epidural Blockade Prediction Model.Evidence-based complementary and alternative medicine : eCAM · 2022
    Article
  6. Review
  7. Article
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Yukako AbukawaDepartment of Anesthesia and Critical Care, Tokyo Women's Medical University, Tokyo, Japan. yukako1@rg8.so-net.ne.jp.
Koichi HirokiDepartment of Anesthesia and Critical Care, Tokyo Women's Medical University, Tokyo, Japan.
Nobutada MoriokaDepartment of Anesthesia and Critical Care, Tokyo Women's Medical University, Tokyo, Japan.
Hiroko IwakiriDepartment of Anesthesia and Critical Care, Tokyo Women's Medical University, Tokyo, Japan.
Tomoko FukadaDepartment of Anesthesia and Critical Care, Tokyo Women's Medical University, Tokyo, Japan.
Hideyuki HiguchiDepartment of Anesthesia and Critical Care, Tokyo Women's Medical University, Tokyo, Japan.
Makoto OzakiDepartment of Anesthesia and Critical Care, Tokyo Women's Medical University, Tokyo, Japan.
Tokyo Women's Medical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCaudal block is easily performed because the landmarks are superficial. However, the sacral hiatus is small and shallow in pediatric patients. In the present study, we evaluated under general anesthesia whether the distance between the bilateral superolateral sacral crests increased with growth, whether an equilateral triangle was formed between the apex of the sacral hiatus and the bilateral superolateral sacral crests, and whether expansion of the epidural space could be confirmed by ultrasound.

methodsThis prospective observational study included 282 children who were ASA I-II. Under general anesthesia, each patient was placed in the lateral bent knees position, and the attending anesthesiologist drew an equilateral triangle and measured the distance between the bilateral superolateral sacral crests along a line forming the base of the triangle. Then the sacral hiatus was identified by ultrasound. Differences of the distance between the anatomical landmarks measured by the anesthetist and by ultrasound were evaluated.

resultsTwo patients were excluded because the superolateral sacral crests and sacral hiatus could not be palpated. The base of the triangle increased in proportion to age up to 10 years old, with a significant correlation between age and the length of the base (Spearman's r value = 0.97). The triangle was not an equilateral triangle under 7 years old. The sacral hiatus could be identified by ultrasound and we could confirm expansion of the epidural space in all patients.

conclusionWe observed a correlation between age and the length of the triangle base in children under 10 years old. Although detection of the anatomical landmarks by palpation differed from identification by ultrasound in pediatric patients, performing ultrasound is important. Epinephrine should be added to the anesthetic to avoid complications.

trial registrationCurrent Controlled Trials UMIN000017898 . Registered 14 June 2015. Date of protocol fixation was 1(st) December, 2008 and Anticipated trial start date was 5(th) January, 2009.

Indexed as

Age FactorsAnesthesia, CaudalAnesthesia, EpiduralChildChild, PreschoolEpidural SpaceEpinephrineFemaleHumansInfantMaleProspective StudiesSacrumUltrasonography, InterventionalEpinephrine

Identifiers

PMID26169595
PMCPMC4499894
OpenAlexW1659031623

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.