1452:
1462:
203:. It predates the lumbar epidural approach which was described by [[Fidel Pagés |Fidel Pagés Miravé]] in 1921. However, the high failure rate found in caudal anesthesia (5–10%) limited its popularity until the 1940s when it resurfaced in obstetrics anaesthesia. The first publication to describe caudal anaesthesia in children was published by Meredith Campbell in 1933.
29:
85:
Caudal anesthesia may be favored for sub-umbilical region surgeries in the pediatric population, such as inguinal hernia repair, circumcision, hypospadias repair, anal atresia, or to immobilise newborns with hip dysplasia. Success rate is limited when used for mid-abdominal interventions such as
186:
A caudal block may be performed by using anatomic landmarks to guide needle insertion. However, greatest accuracy is obtained by performing caudal blocks using imaging guidance, such as ultrasound or fluoroscopy. Common local anesthetic drugs for caudal blockade are bupivacaine and ropivacaine.
62:
conducted by accessing the epidural space via the sacral hiatus. It is typically used in paediatrics to provide peri- and post-operative analgesia for surgeries below the umbilicus. In adults, it can be used in the context of anorectal surgery or for chronic low back pain management.
596:
Disma N, Frawley G, Mameli L, Pistorio A, Alberighi OD, Montobbio G, Tuo P (February 2011). "Effect of epidural clonidine on minimum local anesthetic concentration (ED50) of levobupivacaine for caudal block in children".
379:"The European Society of Regional Anaesthesia and Pain Therapy and the American Society of Regional Anesthesia and Pain Medicine Joint Committee Practice Advisory on Controversial Topics in Pediatric Regional Anesthesia"
1392:
1203:
1407:
282:
Dernek B, Aydoğmuş S, Ulusoy İ, Duymuş TM, Ersoy S, Kesiktaş FN, et al. (2022). "Caudal epidural steroid injection for chronic low back pain: A prospective analysis of 107 patients".
89:
It may also be used in patients with lumbar spinal stenosis, lumbar spinal radiculopathy, postlaminectomy pain, or nonspecific chronic low back pain that fail conservative treatment.
1437:
130:
Serious complications are infrequent. When they occur, they are similar those encountered with lumbar epidural block. Some of the risks associated with caudal anesthesia include:
1422:
1084:
547:"General versus general anaesthesia combined with caudal block in laparoscopic-assisted Soave pull-through of Hirschsprung disease: a retrospective study"
1387:
1432:
1039:
955:
784:
212:
1417:
1356:
1335:
675:
Pandya C, Mehta K, Patel K, Panchasara K (2014). "Pediatric regional anesthesia- A comparison between pediatric spinal and caudal anesthesia".
1397:
478:
263:
711:
1003:
1427:
1238:
821:
1315:
1114:
86:
umbilical hernia repair. This is due to the unpredictable [[Anatomical terms of location |cephalad]] spread of the local anesthetics.
1325:
1233:
748:
170:
The most common complications of the anatomic technique for caudal block include: needle misplacement, subarachnoid puncture, and
1188:
866:
187:
Opioids, ketamine or opioids are common drug added as they prolong the postoperative analgesia while minimizing the motor block.
1366:
1320:
1142:
836:
1412:
1371:
1018:
114:
Contraindications to caudal anesthesia include patient or guardian refusal, localized infection over the sacral area such as
466:
1402:
1361:
1254:
873:
767:
1486:
909:
1259:
924:
1305:
1167:
1079:
222:
1213:
919:
163:
1274:
1228:
1094:
985:
704:
965:
74:
Caudal anaesthesia is a relatively low-risk technique commonly used, either on its own or in combination with
1455:
1279:
1269:
1223:
914:
904:
826:
789:
1330:
1218:
1465:
1152:
841:
806:
119:
196:
1264:
1198:
1193:
1127:
1104:
1008:
200:
59:
122:. It should also be avoided in case of allergies to local anesthetics to be used for the procedure.
1122:
980:
970:
861:
851:
816:
811:
755:
738:
697:
79:
134:
Needle misplacement leading to subdural, intravascular, intraosseous or antesacral injection with
1208:
1064:
934:
846:
831:
794:
779:
772:
622:
408:
307:
232:
166:, more frequently following caudal anesthesia than it does following lumbar or thoracic blocks.
1310:
1137:
1132:
1023:
950:
856:
657:
640:
Waurick K, Waurick R (July 2015). "" [History and
Technique of Epidural Anaesthesia].
614:
578:
527:
474:
440:
400:
359:
299:
259:
115:
33:
Canal block showing needle puncture over sacral area with the patient in the lateral position
1300:
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495:
354:
329:
377:
Ivani G, Suresh S, Ecoffey C, Bosenberg A, Lonnqvist PA, Krane E, et al. (2015).
330:"Caudal epidural blocks in paediatric patients: a review and practical considerations"
1480:
1284:
1172:
1074:
899:
610:
412:
311:
175:
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975:
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378:
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689:
432:
171:
152:
563:
1099:
894:
720:
345:
146:
66:
It can be used as an alternative to general anaesthesia or as adjunct to it.
41:
661:
618:
582:
531:
512:
444:
404:
363:
303:
653:
28:
1044:
743:
217:
75:
545:
Lin Z, Fang Y, Yan L, Lin Y, Liu M, Zhang B, et al. (August 2021).
295:
135:
496:"Caudal Epidural Block: An Updated Review of Anatomy and Techniques"
642:
Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie
254:
Butterworth, John F.; Mackey, David C.; Wasnick, John D. (2022).
471:
NYSORA Textbook of
Regional Anesthesia and Acute Pain Management
693:
195:
Caudal anesthesia was first described independently in 1901 by
1393:
American
Society of Anesthesia Technologists & Technicians
99:
Acute and chronic pain refractory to conservative management
1357:
Helsinki
Declaration for Patient Safety in Anaesthesiology
1204:
Effects of early-life exposures to anesthesia on the brain
1408:
1438:
European
Society of Anaesthesiology and Intensive Care
105:
Patients who are "anticoagulated" or have coagulopathy
1423:
Australian and New
Zealand College of Anaesthetists
1380:
1344:
1293:
1247:
1181:
1113:
1032:
996:
943:
882:
731:
21:
328:Wiegele M, Marhofer P, Lönnqvist PA (April 2019).
284:Journal of Back and Musculoskeletal Rehabilitation
96:Obstetrics and general surgery below the umbilicus
460:
458:
456:
454:
439:. Treasure Island (FL): StatPearls Publishing.
258:(7th ed.). McGraw Hill. pp. 995–996.
256:Morgan & Mikhail's Clinical Anesthesiology
705:
8:
1085:Intraoperative neurophysiological monitoring
102:Patients with previous lumbar spine surgery
1388:American Association of Nurse Anesthetists
712:
698:
690:
27:
1433:International Anesthesia Research Society
1040:ASA physical status classification system
572:
562:
521:
511:
426:
424:
422:
394:
353:
323:
321:
785:Combined spinal and epidural anaesthesia
277:
275:
213:Combined spinal and epidural anaesthesia
1418:Association of Veterinary Anaesthetists
243:
18:
16:Form of neuraxial regional anaesthesia
1398:American Society of Anesthesiologists
383:Regional Anesthesia and Pain Medicine
7:
1403:Anaesthesia Trauma and Critical Care
249:
247:
1428:Australian Society of Anaesthetists
1336:Physicians' assistant (anaesthesia)
1239:Postoperative residual curarization
431:Sanghvi C, Dua A (September 2022).
118:, severe coagulopathy and elevated
37:
1316:Operating department practitioners
14:
1326:Certified anesthesia technologist
1234:Postoperative nausea and vomiting
749:Procedural sedation and analgesia
1460:
1451:
1450:
867:Transverse abdominis plane block
611:10.1111/j.1460-9592.2010.03478.x
467:"Chapter 15. caudal anesthesia."
1461:
1367:History of neuraxial anesthesia
1321:Certified anesthesia technician
1143:Double-lumen endobronchial tube
1004:Blood–gas partition coefficient
837:Intravenous regional anesthesia
677:NHL Journal of Medical Sciences
1413:Royal College of Anaesthetists
1372:History of tracheal intubation
1019:Minimum alveolar concentration
956:Anesthesia provision in the US
465:Candido KD, Winnie AP (2007).
334:British Journal of Anaesthesia
1:
1362:History of general anesthesia
874:Total intravenous anaesthesia
822:Inferior alveolar nerve block
768:Continuous wound infiltration
500:BioMed Research International
925:Neuromuscular-blocking drugs
396:10.1097/AAP.0000000000000280
1260:Critical emergency medicine
1503:
1306:Anesthesiologist assistant
1168:Relative analgesia machine
564:10.1186/s12871-021-01431-5
223:Intrathecal administration
1446:
1214:Local anesthetic toxicity
648:(7–8): 476–82, quiz 483.
346:10.1016/j.bja.2018.11.030
164:Local anesthetic toxicity
157:Injury to the nerve roots
58:) is a form of neuraxial
38:
26:
1229:Postanesthetic shivering
1095:Neuromuscular monitoring
986:Rapid sequence induction
915:Inhalational anesthetics
1280:Oral sedation dentistry
1270:Intensive care medicine
1224:Perioperative mortality
1080:Guedel's classification
827:Intercostal nerve block
494:Kao SC, Lin CS (2017).
149:or sacral osteomyelitis
126:Risks and complications
1331:Anaesthetic technician
1219:Malignant hyperthermia
1153:Laryngeal mask airway
997:Scientific principles
966:Dogliotti's principle
842:Occipital nerve block
807:Brachial plexus block
654:10.1055/s-0041-100845
469:. In Hadzic A (ed.).
120:intracranial pressure
92:List of indications:
1199:Drug-induced amnesia
1194:Anesthesia awareness
1128:Anesthetic vaporizer
1105:Thyromental distance
1009:Concentration effect
883:Pharmacologic agents
852:Pudendal nerve block
599:Pediatric Anesthesia
513:10.1155/2017/9217145
433:"Caudal Anesthesia."
201:Jean-Athanase Sicard
60:regional anaesthesia
1487:Regional anesthesia
1123:Anaesthetic machine
981:Tracheal intubation
971:Intravenous therapy
910:General anesthetics
862:Sciatic nerve block
817:Femoral nerve block
812:Fascia iliaca block
790:Epidural anesthesia
756:Twilight anesthesia
141:Infection, such as
80:general anaesthesia
1209:Emergence delirium
1189:Allergic reactions
1065:Entropy monitoring
847:Paracervical block
832:Interpleural block
795:Spinal anaesthesia
780:Neuraxial blockade
551:BMC Anesthesiology
296:10.3233/BMR-200262
233:Spinal anaesthesia
153:Low blood pressure
52:Caudal anaesthesia
22:Caudal anaesthesia
1474:
1473:
1311:Nurse anesthetist
1138:Bronchial blocker
1133:Arterial catheter
1024:Second gas effect
951:Airway management
920:Local anesthetics
857:Retrobulbar block
480:978-0-07-144906-9
265:978-1-260-47379-7
160:Epidural hematoma
116:pilonidal disease
110:Contraindications
56:caudal anesthesia
49:
48:
1494:
1464:
1463:
1454:
1453:
1301:Anesthesiologist
1090:Mallampati score
1050:Bispectral index
890:Anticholinergics
714:
707:
700:
691:
685:
684:
672:
666:
665:
637:
631:
630:
593:
587:
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576:
566:
542:
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535:
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515:
491:
485:
484:
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448:
428:
417:
416:
398:
374:
368:
367:
357:
325:
316:
315:
279:
270:
269:
251:
197:Fernand Cathelin
143:epidural abscess
42:edit on Wikidata
31:
19:
1502:
1501:
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1496:
1495:
1493:
1492:
1491:
1477:
1476:
1475:
1470:
1442:
1376:
1340:
1289:
1243:
1177:
1109:
1055:Body mass index
1028:
992:
939:
905:Benzodiazepines
878:
727:
718:
688:
674:
673:
669:
639:
638:
634:
595:
594:
590:
544:
543:
539:
493:
492:
488:
481:
473:. McGraw Hill.
464:
463:
452:
430:
429:
420:
376:
375:
371:
327:
326:
319:
281:
280:
273:
266:
253:
252:
245:
241:
228:Lumbar puncture
209:
193:
184:
128:
112:
72:
45:
34:
17:
12:
11:
5:
1500:
1498:
1490:
1489:
1479:
1478:
1472:
1471:
1469:
1468:
1458:
1447:
1444:
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1405:
1400:
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1359:
1354:
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1338:
1333:
1328:
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1295:
1291:
1290:
1288:
1287:
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1277:
1272:
1267:
1262:
1257:
1255:Cardiothoracic
1251:
1249:
1248:Subspecialties
1245:
1244:
1242:
1241:
1236:
1231:
1226:
1221:
1216:
1211:
1206:
1201:
1196:
1191:
1185:
1183:
1179:
1178:
1176:
1175:
1170:
1165:
1163:Magill forceps
1160:
1158:Laryngeal tube
1155:
1150:
1145:
1140:
1135:
1130:
1125:
1119:
1117:
1111:
1110:
1108:
1107:
1102:
1097:
1092:
1087:
1082:
1077:
1072:
1070:Fick principle
1067:
1062:
1057:
1052:
1047:
1042:
1036:
1034:
1030:
1029:
1027:
1026:
1021:
1016:
1011:
1006:
1000:
998:
994:
993:
991:
990:
989:
988:
978:
973:
968:
963:
958:
953:
947:
945:
941:
940:
938:
937:
932:
927:
922:
917:
912:
907:
902:
900:Butyrophenones
897:
892:
886:
884:
880:
879:
877:
876:
871:
870:
869:
864:
859:
854:
849:
844:
839:
834:
829:
824:
819:
814:
809:
799:
798:
797:
792:
787:
777:
776:
775:
770:
760:
759:
758:
753:
752:
751:
735:
733:
729:
728:
725:anesthesiology
719:
717:
716:
709:
702:
694:
687:
686:
667:
632:
605:(2): 128–135.
588:
537:
486:
479:
450:
418:
389:(5): 526–532.
369:
340:(4): 509–517.
317:
290:(1): 135–139.
271:
264:
242:
240:
237:
236:
235:
230:
225:
220:
215:
208:
205:
192:
189:
183:
180:
168:
167:
161:
158:
155:
150:
139:
127:
124:
111:
108:
107:
106:
103:
100:
97:
71:
68:
47:
46:
39:
36:
35:
32:
24:
23:
15:
13:
10:
9:
6:
4:
3:
2:
1499:
1488:
1485:
1484:
1482:
1467:
1459:
1457:
1449:
1448:
1445:
1439:
1436:
1434:
1431:
1429:
1426:
1424:
1421:
1419:
1416:
1414:
1411:
1409:
1406:
1404:
1401:
1399:
1396:
1394:
1391:
1389:
1386:
1385:
1383:
1381:Organizations
1379:
1373:
1370:
1368:
1365:
1363:
1360:
1358:
1355:
1353:
1350:
1349:
1347:
1343:
1337:
1334:
1332:
1329:
1327:
1324:
1322:
1319:
1317:
1314:
1312:
1309:
1307:
1304:
1302:
1299:
1298:
1296:
1292:
1286:
1285:Pain medicine
1283:
1281:
1278:
1276:
1273:
1271:
1268:
1266:
1263:
1261:
1258:
1256:
1253:
1252:
1250:
1246:
1240:
1237:
1235:
1232:
1230:
1227:
1225:
1222:
1220:
1217:
1215:
1212:
1210:
1207:
1205:
1202:
1200:
1197:
1195:
1192:
1190:
1187:
1186:
1184:
1182:Complications
1180:
1174:
1173:Tracheal tube
1171:
1169:
1166:
1164:
1161:
1159:
1156:
1154:
1151:
1149:
1146:
1144:
1141:
1139:
1136:
1134:
1131:
1129:
1126:
1124:
1121:
1120:
1118:
1116:
1112:
1106:
1103:
1101:
1098:
1096:
1093:
1091:
1088:
1086:
1083:
1081:
1078:
1076:
1075:Goldman index
1073:
1071:
1068:
1066:
1063:
1061:
1058:
1056:
1053:
1051:
1048:
1046:
1043:
1041:
1038:
1037:
1035:
1031:
1025:
1022:
1020:
1017:
1015:
1012:
1010:
1007:
1005:
1002:
1001:
999:
995:
987:
984:
983:
982:
979:
977:
974:
972:
969:
967:
964:
962:
959:
957:
954:
952:
949:
948:
946:
942:
936:
933:
931:
928:
926:
923:
921:
918:
916:
913:
911:
908:
906:
903:
901:
898:
896:
893:
891:
888:
887:
885:
881:
875:
872:
868:
865:
863:
860:
858:
855:
853:
850:
848:
845:
843:
840:
838:
835:
833:
830:
828:
825:
823:
820:
818:
815:
813:
810:
808:
805:
804:
803:
800:
796:
793:
791:
788:
786:
783:
782:
781:
778:
774:
771:
769:
766:
765:
764:
761:
757:
754:
750:
747:
746:
745:
742:
741:
740:
737:
736:
734:
730:
726:
722:
715:
710:
708:
703:
701:
696:
695:
692:
682:
678:
671:
668:
663:
659:
655:
651:
647:
644:(in German).
643:
636:
633:
628:
624:
620:
616:
612:
608:
604:
600:
592:
589:
584:
580:
575:
570:
565:
560:
556:
552:
548:
541:
538:
533:
529:
524:
519:
514:
509:
505:
501:
497:
490:
487:
482:
476:
472:
468:
461:
459:
457:
455:
451:
446:
442:
438:
434:
427:
425:
423:
419:
414:
410:
406:
402:
397:
392:
388:
384:
380:
373:
370:
365:
361:
356:
351:
347:
343:
339:
335:
331:
324:
322:
318:
313:
309:
305:
301:
297:
293:
289:
285:
278:
276:
272:
267:
261:
257:
250:
248:
244:
238:
234:
231:
229:
226:
224:
221:
219:
216:
214:
211:
210:
206:
204:
202:
198:
190:
188:
181:
179:
177:
176:intravascular
173:
165:
162:
159:
156:
154:
151:
148:
144:
140:
137:
133:
132:
131:
125:
123:
121:
117:
109:
104:
101:
98:
95:
94:
93:
90:
87:
83:
81:
77:
69:
67:
64:
61:
57:
53:
43:
30:
25:
20:
1148:Gas cylinder
1033:Measurements
976:Laryngoscopy
961:Bronchoscopy
680:
676:
670:
645:
641:
635:
602:
598:
591:
554:
550:
540:
503:
499:
489:
470:
436:
386:
382:
372:
337:
333:
287:
283:
255:
194:
185:
178:injections.
169:
129:
113:
91:
88:
84:
73:
65:
55:
51:
50:
1352:ACE mixture
1294:Professions
1115:Instruments
1060:Capnography
1014:Fink effect
895:Antiemetics
802:Nerve block
683:(1): 72–76.
506:: 9217145.
437:StatPearls
172:intrathecal
138:perforation
70:Indications
1100:Pain scale
944:Techniques
721:Anesthesia
557:(1): 209.
239:References
147:meningitis
1275:Obstetric
1265:Geriatric
935:Sedatives
413:205430620
312:235492058
182:Technique
1481:Category
1456:Category
1045:Baricity
744:Sedation
662:26230893
627:25897059
619:21159021
583:34461833
532:28337460
445:31869157
405:26192549
364:30857607
304:34151825
218:Epidural
207:See also
76:sedation
1466:Outline
1345:History
930:Opioids
773:Topical
739:General
574:8404309
523:5346404
355:6435837
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136:rectum
763:Local
732:Types
623:S2CID
409:S2CID
308:S2CID
40:[
723:and
658:PMID
615:PMID
579:PMID
528:PMID
504:2017
475:ISBN
441:PMID
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260:ISBN
199:and
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650:doi
607:doi
569:PMC
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