Where is the apex of the sacral hiatus for caudal epidural block in the pediatric population? A radio-anatomic study

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dc.contributor.authorCicekcibasi, Aynur Emine
dc.contributor.authorBorazan, Hale
dc.contributor.authorArican, Sule
dc.contributor.authorYilmaz, Mehmet Tugrul
dc.contributor.authorSakarya, Mehmet Emin
dc.date.accessioned2024-02-23T13:55:51Z
dc.date.available2024-02-23T13:55:51Z
dc.date.issued2014
dc.departmentNEÜen_US
dc.description.abstractCaudal epidural block (CEB), administered through the sacral hiatus, is a regional anesthetic technique commonly used in children. To facilitate and optimize pediatric CEB, morphometric data that may be important for the sacral hiatus have been obtained using multidetector computed tomography (MDCT). This study is the first radio-anatomic study designed to address this topic in children. Images of 79 children (39 girls and 40 boys between 1 and 9 years old) were divided into three groups according to age [group I (ages 1-3), group II (ages 4-6), and group III (ages 7-9)] and were retrospectively examined. Data were gathered via 3D volume-rendered images. Measurements included the height and width of the sacral hiatus, S2-S4 (sacral vertebra) distance, the distances between the poles of the unfused spinous process of each sacral vertebra, and the dimensions of an imaginary triangle formed between the right and left posterior superior iliac spines (PSIS) and the apex of the sacral hiatus. The most frequently fused spinous process was at S2 level. The mean S2-S4 distance was 1.36 cm for group I, 1.78 cm for group II, and 2.17 cm for group III. There was not the imaginary equilateral triangle used in the method of finding the sacral hiatus for CEB, and the apex of this triangle did not occur at the standard level (S4) in most of the children. It was observed that the apex deriving from the most distal fused spinous process was at the level of S2 in one of two children. Dural puncture is inevitable for CEB applied at the S2 level. Consequently, CEB should be applied below this level (range, 1.36-2.17 cm) from the midpoint of the interspinous distance between the PSIS (at the same level with S2) in children aged 1-9 years.en_US
dc.identifier.doi10.1007/s00540-013-1758-6
dc.identifier.endpage575en_US
dc.identifier.issn0913-8668
dc.identifier.issn1438-8359
dc.identifier.issue4en_US
dc.identifier.pmid24343091en_US
dc.identifier.scopus2-s2.0-84905869347en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage569en_US
dc.identifier.urihttps://doi.org/10.1007/s00540-013-1758-6
dc.identifier.urihttps://hdl.handle.net/20.500.12452/10988
dc.identifier.volume28en_US
dc.identifier.wosWOS:000340520600015en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringer Japan Kken_US
dc.relation.ispartofJournal Of Anesthesiaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectRegional Anesthesiaen_US
dc.subjectCaudal Epidural Blocken_US
dc.subjectLandmarksen_US
dc.subjectPosterior Superior Iliac Spineen_US
dc.subjectSacral Hiatusen_US
dc.titleWhere is the apex of the sacral hiatus for caudal epidural block in the pediatric population? A radio-anatomic studyen_US
dc.typeArticleen_US

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