title: Anatomical investigations for appropriate needle positioning for thoracic paravertebral blockade in children.
abstract: OBJECTIVE
  Clinicians hesitate to perform thoracic paravertebral blockade (TPVB) in children due to the potential high risk of adverse effects. No paediatric anatomical guidelines for TPVB exist. This study aimed to estimate the appropriate depth and distance for safe needle positioning in children.
  
  
  METHODS
  The depth (D) from the skin to the paravertebral space and the distance (A) from the spinous process to the needle entry point on the skin were measured using chest computed tomography (CT) in children aged between 1 and 9 years. Correlations between age, gender, weight, height, body mass index (BMI) and each of the anatomical measurements were analysed.
  
  
  RESULTS
  Each measurement correlated significantly with age, weight and height, but not with BMI (n = 373 children). Measurements A and D could be calculated by: A = 13.56 + (0.33 × age [years]) + (0.06 × weight [kg]) + 0.47 × (gender [female = 0, male = 1]); and D = 17.49 - (0.35 × age [years]) + (0.55 × weight [kg]).
  
  
  CONCLUSIONS
  These anatomical guidelines for TPVB are recommended to help prevent anaesthetic complications such as pneumothorax, when ultrasonography and CT are unavailable.
authors: Department of Anaesthesia and Pain Medicine, Soonchunhyang University Hospital Cheonan, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea.
authors: S H
authors: SH
authors: Yoo
authors: D H
authors: DH
authors: Lee
authors: D E
authors: DE
authors: Moon
authors: H K
authors: HK
authors: Song
authors: Y
authors: Y
authors: Jang
authors: J B
authors: JB
authors: Kim
mesh_terms: D000758:Anesthesia / Q000009:adverse effects; D000777:Anesthetics / Q000008:administration & dosage* / Q000009:adverse effects; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D064847:Multimodal Imaging; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D056888:Patient Positioning; D011030:Pneumothorax; D049268:Positron-Emission Tomography; D013904:Thoracic Vertebrae / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D000777:Anesthetics