Understanding Caudal Block in Anaesthesia: Safe and Effective Technique for Lower Body Surgeries in Children

 Caudal block is a commonly used regional anaesthesia technique, especially in paediatric patients. It involves injecting local anaesthetic into the caudal epidural space through the sacral hiatus. This method provides effective analgesia for surgeries below the umbilicus, such as hernia repair, circumcision, and lower limb procedures.

Introduction to Caudal Block

Caudal anaesthesia is a type of neuraxial block derived from the epidural approach. It is widely practiced due to its simplicity, safety, and high success rate in children. The technique is less commonly used in adults due to anatomical variations.

Anatomy and Technique

The block targets the caudal epidural space, accessed through the sacral hiatus. The patient is usually placed in the lateral or prone position. After sterile preparation, a needle is inserted into the hiatus, and the anaesthetic is administered. Dosage is based on the child’s weight and height.

Drugs Used in Caudal Block

Commonly used agents include bupivacaine, ropivacaine, and lignocaine. Adjuvants like clonidine or fentanyl may be added to prolong analgesia. Careful dosage calculation is essential to avoid toxicity.

Indications and Benefits

Caudal block is ideal for infra-umbilical surgeries in paediatrics. It reduces the need for systemic analgesics postoperatively and lowers the requirement for inhalational agents intraoperatively, thereby improving safety.

Complications and Precautions

While generally safe, complications like infection, bleeding, or rare neurological injury can occur. Proper technique, sterile conditions, and correct dosing are vital for patient safety.

Caudal block remains a trusted choice in paediatric anaesthesia for lower abdominal and limb surgeries, offering excellent analgesia with minimal complications when performed correctly.

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