Caudal block

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Abstract

The caudal blockade is one of the blockades typical of the paediatric age. Depending on the dose employed can allow any intervention under the umbilicus. Its technical achievement, as soon as a suitable level of formation was reached, it is not specially complicated. The identification of the sacred horns and the penetration of the sacrococcigeal ligament are the basis of the above mentioned skill. The complications are relatively slightly frequent (spinal anesthesia, hematic punction or intraosseus injection), while the mistake of the blockade for subcutaneous injection is much more frequent. The dosage of the local anaesthetic is really difficult to calculate. For this reason there are different exact formulae adjusted to the weight and/or the age for the above mentioned calculation, and nonetheless, the authors coincide with a great interindividual change. The calculation of the maximum dose and the employment of vasoconstrictores allows to avoid cases of systemic toxicity. The employment of catheters for caudal route can allow to increase the efficacy in certain cases of nursing patients and to prolong the analgesia. The physiological hemodymanics and respiratory effects are, in general, tolerated well. The endocrine effects from abolition of the response to the stress are specially favorable with this technique.

Author-supplied keywords

  • analgesia
  • bupivacaine
  • catheter
  • caudal anesthesia
  • child
  • drug efficacy
  • endocrine system
  • epinephrine
  • hemodynamics
  • human
  • lidocaine
  • mepivacaine
  • nerve block
  • pediatric anesthesia
  • pediatric surgery
  • regional anesthesia
  • respiratory system
  • review
  • spinal anesthesia
  • umbilicus

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Authors

  • Blanco Vargas D.

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