Key result
A 1 mm/kg weight guideline accurately estimates pediatric skin-epidural distance.
Why the study?
The usefulness of 1 mm.kg-1 as a guideline for skin-epidural distance in children was assessed due to limited data across age and weight ranges.
Does the 1 mm/kg rule accurately estimate skin-epidural distance in children?
Observational (n=274)
Does the 1 mm/kg rule accurately estimate skin-epidural distance in children?
Effect estimate: R2 = 0.74
The 1 mm/kg rule is a useful guideline for estimating skin-epidural distance in children aged 6 months to 10 years.
Supports 1 mm.kg-1 as reliable skin-epidural estimate in children; confirms weight-based correlation for pediatric epidural guidance.
The skin-epidural distance was measured in 274 children to assess the usefulness of 1 mm.kg-1 as a guideline. Children aged between 2 days and 16 years, weighing between 2 and 43 kg were investigated. Lumbar epidurals were performed under general anaesthesia using a midline approach in the L3-4 interspace with the patient in the lateral position. Good correlation between skin-epidural distance and age and weight was demonstrated. No statistical difference was shown when plotting the best fit regression line: skin-epidural distance (mm) = 0.8 weight (kg) + 3.93 (R2 = 0.74) and its 95% confidence limits and skin-epidural distance (mm) = weight (kg) for children between 6 months and 10 years. Poor correlation was noted below 6 months (n = 22) and over 10 years (n = 19). No dural puncture or bloody tap occurred. One mm.kg-1 body weight was shown to be a useful guideline for children between 6 months and 10 years of age.
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Bösenberg et al. (1995) conducted an observational in Children requiring lumbar epidurals (n=274). Weight-based guideline (1 mm/kg) for skin-epidural distance was evaluated on Correlation between skin-epidural distance and weight (R2 = 0.74). A 1 mm/kg body weight guideline accurately estimated skin-epidural distance in children aged 6 months to 10 years, showing good correlation with weight (R2 = 0.74).
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