title: Migration of pediatric epidural catheters.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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 2 days 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.
  
  
  RESULTS
  It was determined that epidural catheters migrated more frequently in patients <10 kg and 10-40 kg, when compared to those >40 kg P < 0.001. The average migration seen on X-ray was 1.1 levels inward in those <40 kg and 0.3 levels inward in those >40 kg. The incidence of catheters discontinued secondary to falling out, or migrating in, was also increased in those patients <40 kg when compared to those >40 kg.
  
  
  CONCLUSIONS
  Results suggest that epidural catheters move inward more frequently and fall out more frequently in patients <40 kg.
authors.affiliation: Department of Pediatric Anesthesia, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Strandness
authors.forename: Marisa
authors.initials: M
authors.lastname: Wiktor
authors.forename: Jaya
authors.initials: J
authors.lastname: Varadarajan
authors.forename: Steven
authors.initials: S
authors.lastname: Weisman
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015360:Analgesia, Epidural / Q000295:instrumentation*; D000767:Anesthesia, Epidural / Q000295:instrumentation*; D057785:Catheters; D002675:Child, Preschool; D004824:Epidural Space / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012189:Retrospective Studies
keywords: acute pain service; complications; epidural analgesia; epidural anesthesia; pediatrics; postoperative pain