Fluoroscopy guidance has markedly improved the successful rate of caudal epidural block [3-5, 23] and is now considered as the gold standard in performing caudal block
. However, routine use of fluoroscopy for caudal epidural block is limited by radiation exposure, cost, and special space requirement.
Duration of caudal analgesia was defined as the interval from caudal block
until the first analgesic supplementation.
with bupivacaine 0.25% was given by experienced consultant anesthetist for analgesia.
Unilateral groin surgery in children: will the addition of an ultrasound-guided ilioinguinal nerve block enhance the duration of analgesia of a single-shot caudal block
? Paediatr Anaesth 2009; 19:892-898.
Neostigmine is a relatively new drug being tried as an adjunct for caudal block
in children: Ropivacaine compared with bupivacaine.
The main disadvantage with single shot caudal block
with plain local anaesthetic is its short duration of action.
Fifteen minutes after the caudal block
, surgery commenced.
This study was undertaken to evaluate the efficacy of ketamine added to bupivacaine in caudal block
to provide postoperative analgesia in paediatric patients.
The role of performing a caudal block
prior to incision after general anaesthesia reduces the need of sedative opioids for pain relief and decreases the need of volatile anaesthetics for maintenance of anaesthesia intraoperatively.
Since then studies have described the indications for paediatric caudal block
, the level of analgesia, recommended doses and pharmacokinetics of local anaesthetics used in caudal anaesthesia and the general or specific advantages and disadvantages of the technique.
Single-dose caudal block
for circumcision surgery in children is well established as a method for providing effective postoperative pain relief, while potentially decreasing the need for general anesthetic during the procedure (1).
(2) Sacral hiatus is clinically important as caudal block
, also known as caudal epidural anaesthesia, is a commonly undertaken procedure carried out either for the management of chronic back pain or while doing major abdominal surgeries.
All children were given standard inhalational general anaesthesia with controlled ventilation and standard monitoring with ECG, SPO2, NIBP and EtCO2 and a single dose caudal block
as below was administered by an anaesthesiologist blinded to the drug mixture:
Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block