CAUDAL BLOCKS: A FEW FACTS

🎯 Most effective for children <20 Kg (~ under 6 years of age) and for dermatomes below T10

🎯Common side effects are weakness of legs, urinary retention etc

🎯 The incidence of epidural hematoma has been reported as 1 in 80000 cases

🎯 Because of this, sometimes a caudal block may necessitate overnight admission 

🎯 Dose calculation can be done using Armitage ( 0.5 mL/kg for lumbosacral & 1 mL/kg for lumbar blockade, with 0.25% levobupivacaine ) or Scott formulas

🎯 Additives used in caudal block:

💉 Preservative free Ketamine: Extend duration of analgesia; not used in infants <6 months of age due to fear of neurotoxicity 

 💉 Clonidine : Extend duration of analgesia; not used in preterm infants and neonates due to higher incidence of bradycardia and apnoea. Provides postoperative sedation also.

🎯 Opioids when used as additives produce side effects like respiratory depression, pruritus & PONV

#EpiduralBlock , #Anaesthesia , #Anesthesia

References: De Beer DAH, Thomas ML. Caudal additives in children: solutions or problems? Br J Anaesth. 2003; 90: 487–498. Patel D. Epidural analgesia for children. Contin Educ Anaesth Crit Care Pain. 2006; 6(2): 63–66.