Performing renal biopsies in children under general anaesthesia in the lateral position

Pediatr Nephrol. 2013 Apr;28(4):671-3. doi: 10.1007/s00467-012-2388-1. Epub 2012 Dec 28.

Abstract

Background: Renal biopsies are usually performed in the prone position, often under general anaesthesia. Because it is theoretically and pragmatically safer to anaesthetise children in the lateral rather than the prone position, we compared the efficacy and safety of ultrasound-guided renal biopsy in these two positions.

Case-diagnosis/treatment: In our department, physician preference dictates positioning during renal biopsy. We retrospectively audited the case notes and biopsy quality of 50 consecutive biopsies performed in each position, reviewing a total of 44 lateral and 47 prone position biopsies. Patient characteristics were similar for age and sex. Endotracheal intubation was carried out in all patients in the prone position and 18 % of patients in the lateral position. All patients were successfully biopsied, and the diagnostic yield and complications were similar in both groups.

Conclusions: Renal biopsy under general anaesthesia is as successful in the lateral position as when it is performed prone. Therefore, the lateral position should be considered as an alternative because it reduces the anaesthetic risk.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Age Factors
  • Anesthesia, General* / adverse effects
  • Child
  • Female
  • Humans
  • Image-Guided Biopsy* / adverse effects
  • Intubation, Intratracheal
  • Kidney / pathology*
  • Kidney Diseases / pathology*
  • Male
  • Patient Positioning* / adverse effects
  • Predictive Value of Tests
  • Prone Position
  • Retrospective Studies