Ultrasound guided pediatric caudal dose: a two-center randomized controlled trial

Abstract Background The drug volume to be used in caudal in pediatric patients has remained an unmet issue since long. We determined the minimum drug volume required to reach T10 level in pediatric patients using ultrasonography and compared it with the already established volume by Armitage formula...

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Main Authors: Kartik Syal, Ankita Chandel, Manjit Singh Kanwar
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-024-02752-x
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author Kartik Syal
Ankita Chandel
Manjit Singh Kanwar
author_facet Kartik Syal
Ankita Chandel
Manjit Singh Kanwar
author_sort Kartik Syal
collection DOAJ
description Abstract Background The drug volume to be used in caudal in pediatric patients has remained an unmet issue since long. We determined the minimum drug volume required to reach T10 level in pediatric patients using ultrasonography and compared it with the already established volume by Armitage formula. Aim To determine the minimum effective caudal local anesthetic dose using ultrasound guidance. Methods Study was performed at two centres and at each centre, 50 pediatric patients (Total 100 patients), aged 1 to 3 years, undergoing below umbilical surgeries were included and randomised into two groups of 25 each (Total 50) to receive ultrasound guided drug volume vs. Armitage formula based volume. The volume required to reach T10 level was assessed with ultrasound in one group. Also, maximum height achieved, cutaneous level achieved after 15 min, FLACC scores 30 min post extubation and parental satisfaction scores were noted. Results The mean drug volume required to reach T10 level in Group U was 0.755 ± 0.053 ml/kg with a P value < 0.001. (Compared to the drug volume of 1 ml/kg using one sample t test). The highest level achieved in both groups were calculated as the mode value of T8 and T7 in Group U and Group A respectively. The highest cutaneous level achieved after 15 min was also calculated as the mode value of T4 in both groups. FLACC scores at 30 min were also comparable. Satisfaction scores were comparable in both groups. Conclusion A volume of 0.7 ml/kg of local anaesthetic in pediatric caudal block is sufficient to achieve a target of T10 level for infraumblical surgeries.
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spelling doaj-art-61da68a67f8645e68bd0839c6aa747682025-08-20T02:13:26ZengBMCBMC Anesthesiology1471-22532024-11-012411610.1186/s12871-024-02752-xUltrasound guided pediatric caudal dose: a two-center randomized controlled trialKartik Syal0Ankita Chandel1Manjit Singh Kanwar2Department of Anaesthesia, Indira Gandhi Medical College and HospitalDepartment of Anaesthesia, Indira Gandhi Medical College and HospitalDepartment of Anaesthesia, Dr Radhakrishnan Gandhi Medical College and HospitalAbstract Background The drug volume to be used in caudal in pediatric patients has remained an unmet issue since long. We determined the minimum drug volume required to reach T10 level in pediatric patients using ultrasonography and compared it with the already established volume by Armitage formula. Aim To determine the minimum effective caudal local anesthetic dose using ultrasound guidance. Methods Study was performed at two centres and at each centre, 50 pediatric patients (Total 100 patients), aged 1 to 3 years, undergoing below umbilical surgeries were included and randomised into two groups of 25 each (Total 50) to receive ultrasound guided drug volume vs. Armitage formula based volume. The volume required to reach T10 level was assessed with ultrasound in one group. Also, maximum height achieved, cutaneous level achieved after 15 min, FLACC scores 30 min post extubation and parental satisfaction scores were noted. Results The mean drug volume required to reach T10 level in Group U was 0.755 ± 0.053 ml/kg with a P value < 0.001. (Compared to the drug volume of 1 ml/kg using one sample t test). The highest level achieved in both groups were calculated as the mode value of T8 and T7 in Group U and Group A respectively. The highest cutaneous level achieved after 15 min was also calculated as the mode value of T4 in both groups. FLACC scores at 30 min were also comparable. Satisfaction scores were comparable in both groups. Conclusion A volume of 0.7 ml/kg of local anaesthetic in pediatric caudal block is sufficient to achieve a target of T10 level for infraumblical surgeries.https://doi.org/10.1186/s12871-024-02752-xCaudalAnesthesiaHerniaUltrasonographyEpiduralAnesthetics
spellingShingle Kartik Syal
Ankita Chandel
Manjit Singh Kanwar
Ultrasound guided pediatric caudal dose: a two-center randomized controlled trial
BMC Anesthesiology
Caudal
Anesthesia
Hernia
Ultrasonography
Epidural
Anesthetics
title Ultrasound guided pediatric caudal dose: a two-center randomized controlled trial
title_full Ultrasound guided pediatric caudal dose: a two-center randomized controlled trial
title_fullStr Ultrasound guided pediatric caudal dose: a two-center randomized controlled trial
title_full_unstemmed Ultrasound guided pediatric caudal dose: a two-center randomized controlled trial
title_short Ultrasound guided pediatric caudal dose: a two-center randomized controlled trial
title_sort ultrasound guided pediatric caudal dose a two center randomized controlled trial
topic Caudal
Anesthesia
Hernia
Ultrasonography
Epidural
Anesthetics
url https://doi.org/10.1186/s12871-024-02752-x
work_keys_str_mv AT kartiksyal ultrasoundguidedpediatriccaudaldoseatwocenterrandomizedcontrolledtrial
AT ankitachandel ultrasoundguidedpediatriccaudaldoseatwocenterrandomizedcontrolledtrial
AT manjitsinghkanwar ultrasoundguidedpediatriccaudaldoseatwocenterrandomizedcontrolledtrial