Current opinion on caudal epidural blockade and its complications in children


Authors: J. Šípek;  V. Mixa
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny 2. LF UK a FN v Motole, Praha
Published in: Anest. intenziv. Med., 27, 2016, č. 2, s. 78-86
Category:

Editor rubriky: Vladimír Mixa

Overview

Caudal block is a type of neuroaxial block (single shot or continuous), in which the local anesthetic is injected through the sacrococcygeal membrane into the caudal epidural area of the spinal canal. It provides analgesia which is important not just in the perioperative but mainly in the postoperative period. The single shot technique is more commonly used in paediatric anesthesia especially due to its very simple performance and low occurrence of complications. The complications include failure, infection or adverse effects of the local anaesthetics or their additives.

The continuous caudal block has higher occurrence of complications caused by the misplacement of the catheter, incorrect dosage or poor postoperative care of the catheter on the ward. Recently there have been increasing voices recommending the abandoning of the continuous caudal, especially the caudo-lumbar and caudo-thoracic blocks, and their replacement by peripheral nerve blocks.

Keywords:
single-shot caudal blocks – continuous caudal blocks – complications of epidural analgesia – paediatric anesthesia – epidural catheter


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