Anest. intenziv. Med. 2019;30(1):33-38 | DOI: 10.36290/aim.2019.007
Caudal block in adult patients and its use in the perioperative periodLéčba bolesti - přehledový článek
- 1 Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Olomouc
- 2 Ústav molekulární a translační medicíny, Lékařská fakulta Univezity Palackého v Olomouci
- 3 Ringerike Hospital, VVHF, Hønefoss, Norsko
- 4 Oddělení anesteziologie, resuscitace a intenzivní medicíny, Krajská nemocnice Tomáše Bati, a. s.
Caudal block is a well-known and thoroughly studied technique of neuraxial anaesthesia routinely performed in paediatric anaesthesia. In adults, however, this method has been used mostly in chronic pain management. Due to more detailed understanding of anatomy and the routine use of ultrasound guidance, caudal block has recently been reintroduced into perioperative care in adults. It is now considered a simple, safe and reliable technique for both anaesthesia and postoperative analgesia in this group of patients. This review describes the anatomy and technical aspects with a focus on ultrasound guidance as well as suitable applications of this block in the perioperative setting in adults.
Keywords: caudal block; regional anaesthesia; ultrasound; analgesia
Received: October 8, 2018; Accepted: November 13, 2018; Published: February 1, 2019 Show citation
References
- Franco A, Cortés J, Díz C, Alvarez J. History of the sacral epidural block. Rev Esp Anestesiol Reanim. 2011 Jan;58:42-47.
- Mai CL, Coté CJ. A history of pediatric anesthesia: a tale of pioneers and equipment. Paediatr Anaesth. 2012;22:511-520.
Go to original source...
Go to PubMed...
- Hurdle MF. Ultrasound-guided spinal procedures for pain: A review. Phys Med Rehabil Clin N Am. 2016;27:673-686.
Go to original source...
Go to PubMed...
- Joo J, Kim J, Lee J. The prevalence of anatomical variations that can cause inadvertent dural puncture when performing caudal block in Koreans: a study using magnetic resonance imaging. Anaesthesia. 2010;65:23-26.
Go to original source...
Go to PubMed...
- Senoglu N, Senoglu M, Ozkan F, et al. The level of termination of the dural sac by MRI and its clinical relevance in caudal epidural block in adults. Surg Radiol Anat. 2013;35:579-584.
Go to original source...
Go to PubMed...
- Kao SC, Lin CS. Caudal epidural block: an updated review of anatomy and techniques. Biomed Res Int. 2017;2017:9217145. doi: 10.1155/2017/9217145.
Go to original source...
Go to PubMed...
- Sekiguchi M, Yabuki S, Satoh K, Kikuchi S. An anatomic study of the sacral hiatus: a basis for successful caudal epidural block. Clin J Pain. 2004;20:51-54.
Go to original source...
Go to PubMed...
- Aggarwal A, Aggarwal A, Harjeet, Sahni D. Morphometry of sacral hiatus and its clinical relevance in caudal epidural block. Surg Radiol Anat. 2009;31:793-800.
Go to original source...
Go to PubMed...
- Aggarwal A, Kaur H, Batra YK, et al. Anatomic consideration of caudal epidural space: a Cadaver study. Clin Anat. 2009;22:730-737.
Go to original source...
Go to PubMed...
- Park GY, Kwon DR, Cho HK. Anatomic differences in the sacral hiatus during caudal epidural injection using ultrasound guidance. J Ultrasound Med. 2015 Dec;34:2143-2148.
Go to original source...
Go to PubMed...
- Kim YH, Park HJ, Cho S, Moon DE. Assessment of factors affecting the difficulty of caudal epidural injections i adults using ultrasound. Pain Res Manag. 2014;19:275-279.
Go to original source...
Go to PubMed...
- Senoglu N, Senoglu M, Oksuz H, et al. Landmarks of the sacral hiatus for caudal epidural block: an anatomical study. Br J Anaesth. 2005;95:692-695.
Go to original source...
Go to PubMed...
- Barham G, Hilton A. Caudal epidurals: the accuracy of blind needle placement and the value of a confirmatory epidurogram. Eur Spine J. 2010;19:1479-1483.
Go to original source...
Go to PubMed...
- Lewis MP, Thomas P, Wilson LF, Mulholland RC. The "whoosh" test: a Clinical test to confirm correct needle placement in caudal epidural injections. Anaesthesia. 1992;47:57-58.
Go to original source...
Go to PubMed...
- Eastwood D, Williams C, Buchan I. Caudal epidurals: the whoosh test. Anaesthesia. 1998;53:305-307.
Go to original source...
Go to PubMed...
- Stitz MY, Sommer HM. Accuracy of blind versus fluoroscopically guided caudal epidural injection. Spine (Phila Pa 1976). 1999;24:1371-1376.
Go to original source...
Go to PubMed...
- Klocke R, Jenkinson T, Glew D. Sonographically guided caudal epidural steroid injections. J Ultrasound Med. 2003;22:1229-1232.
Go to original source...
Go to PubMed...
- Chen CP, Tang SF, Hsu TC, et al. Ultrasound guidance in caudal epidural needle placement. Anesthesiology. 2004;101:181-184.
Go to original source...
Go to PubMed...
- Blanchais A, Le Goff B, Guillot P, et al. Feasibility and safety of ultrasound-guided caudal epidural glucocorticoid injections. Joint Bone Spine. 2010;77:440-444.
Go to original source...
Go to PubMed...
- Chin KJ, Karmakar MK, Peng P. Ultrasonography of the adult thoracic and lumbar spine for central neuraxial blockade. Anesthesiology. 2011;114:1459-1485.
Go to original source...
Go to PubMed...
- Yoon JS, Sim KH, Kim SJ, et al. The feasibility of color Doppler ultrasonography for caudal epidural steroid injection. Pain. 2005;118:210-214.
Go to original source...
Go to PubMed...
- Shanthanna H, Singh B, Guyatt G. A systematic review and meta-analysis of caudal block as compared to noncaudal regional techniques for inguinal surgeries in children. Biomed Res Int. 2014;2014:890626. doi: 10.1155/2014/890626.
Go to original source...
Go to PubMed...
- Guay J, Choi P, Suresh S, et al. Neuraxial blockade for the prevention of postoperative mortality and major morbidity: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2014;25.
Go to original source...
Go to PubMed...
- Apan A, Cuvas O. Caudal block in adults: new horizons with ultrasound. Minerva Anestesiol. 2013;79:1332-1333.
Go to PubMed...
- Köse EA, Öztürk A, Ateş G, Apan A. Caudal epidural block for elderly patients who have limited cardiac reserve. Turkish Journal of Medical Sciences. 2012;42(Sup. 1): 1347-1351.
Go to original source...
- Urabe F, Kimura T, Shimomura T, et al. Prospective comparison of the efficacy of caudal versus periprostatic nerve block, both with intrarectal local anesthesia, during transrectal ultrasonography-guided prostatic needle biopsy. Scand J Urol. 2017;51:245-250.
Go to original source...
Go to PubMed...
- Isoyama-Shirakawa Y, Nakamura K, Abe M, et al. Caudal epidural anesthesia during intracavitary brachytherapy for cervical cancer. J Radiat Res. 2015;56:583-587.
Go to original source...
Go to PubMed...
- Schloss B, Martin D, Tripi J, et al. Caudal epidural blockade for major orthopedic hip surgery in adolescents. Saudi J Anaesth. 2015;9:128-131.
Go to original source...
Go to PubMed...
- Manchikanti L, Knezevic NN, Boswell MV, et al. Epidural injections for lumbar radiculopathy and spinal stenosis: a Comparative systematic review and meta-analysis. Pain Physician. 2016;19:E365-410.
Go to original source...
Go to PubMed...
- Chou R, Hashimoto R, Friedly J, et al. Epidural corticosteroid injections for radiculopathy and spinal stenosis: a Systematic review and meta-analysis. Ann Intern Med. 2015;163:373-381.
Go to original source...
Go to PubMed...
- Lundblad M, Lönnqvist PA. Adjunct analgesic drugs to local anaesthetics for neuroaxial blocks in children. Curr Opin Anaesthesiol. 2016;29:626-631.
Go to original source...
Go to PubMed...