The Indian Anaesthetists’ Forum

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 21  |  Issue : 1  |  Page : 10--15

A comparative study of ultrasound-guided caudal block versus anatomical landmark-based caudal block in pediatric surgical cases


Nethra H Nanjundaswamy, Saraswathi Nagappa, Raghavendra Biligiri Shridhara, Sandya Kalappa 
 Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Nethra H Nanjundaswamy
#SF4, VV Apartments, Contour Road, Padmanabhanagar, Bengaluru - 560 070, Karnataka
India

Background: Caudal block is a popular regional anesthesia technique in pediatrics for anesthesia and perioperative analgesia. Conventional landmark-based technique is a simple technique with good success rate but associated with complications such as dural puncture and venous injection. Ultrasound-guided caudal block is known to improve the success rate and reduce the complications noted with the landmark technique. We aimed to compare the success rates of caudal block in landmark- and ultrasound-guided techniques. Methods: One hundred and twenty-four children under 10 years admitted for infraumbilical surgeries were randomly allocated to Group L and Group U caudal block was administered based on landmarks in Group L and by using ultrasound in Group U. In both the groups, observations noted were success of caudal block, visibility and palpability of sacral cornu; identification of hiatus; first attempt success; number of attempts; block performance time; and complications. In Group U, ultrasound visualization of sacral hiatus, needle, and distension of sacral canal with injection was also noted. Results: Success rates were 81.8% and 92.1% in Group L and Group U, respectively (P = 0.045). Complications noted in Group L were blood tap (23.8%), subcutaneous swelling (15.2%), dural puncture (1.5%), and rectal perforation (1.5%). In Group U, only blood tap (3%) was the complication noted. Block performance was faster in Group L than Group U. There was no significant difference in the first attempt success rate and number of attempts. Conclusion: Ultrasound-guided caudal block improves the success rate, reduces complications, and ensures safety.


How to cite this article:
Nanjundaswamy NH, Nagappa S, Shridhara RB, Kalappa S. A comparative study of ultrasound-guided caudal block versus anatomical landmark-based caudal block in pediatric surgical cases.Indian Anaesth Forum 2020;21:10-15


How to cite this URL:
Nanjundaswamy NH, Nagappa S, Shridhara RB, Kalappa S. A comparative study of ultrasound-guided caudal block versus anatomical landmark-based caudal block in pediatric surgical cases. Indian Anaesth Forum [serial online] 2020 [cited 2020 Sep 18 ];21:10-15
Available from: http://www.theiaforum.org/article.asp?issn=2589-7934;year=2020;volume=21;issue=1;spage=10;epage=15;aulast=Nanjundaswamy;type=0