Abstract
Postoperative pain control in the pediatric population frequently involves epidural catheters placed intraoperatively. A retrospective review of epidural catheter tip position was conducted by evaluation of routine chest anterior-posterior (A-P) X-rays obtained by the surgical and ICU teams. Of the 174 pediatric epidural catheters placed during a 1-year period at Children's Hospital of Wisconsin, 59 pediatric patients with chest X-rays demonstrating epidural catheter tip on at least 2days were reviewed. The change in epidural catheter position was then calculated. The overall reason for discontinuation of epidural analgesia in the larger population was also compiled. It was determined that epidural catheters migrated more frequently in patients <10kg and 10-40kg, when compared to those >40kg P<0.001. The average migration seen on X-ray was 1.1 levels inward in those <40kg and 0.3 levels inward in those >40kg. The incidence of catheters discontinued secondary to falling out, or migrating in, was also increased in those patients <40kg when compared to those >40kg. Results suggest that epidural catheters move inward more frequently and fall out more frequently in patients <40kg.
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