Caudal Extradural Sacral Block
Objectives
• To provide anesthesia and analgesia for perineal, pelvic and abdominal operation by introducing the local anesthetic or opioid analgesic into the caudal epidural space
• Consent to be taken for this procedure.
Position
• Lateral position.
• Prone position with hips slightly flexed over two pillows; legs slightly abducted and toes turn in.
• Knee chest position.
• Knee elbow position.
Premedication
Patient is premedicated with oral drugs.
Procedure
1. Intravenous line secured.
2. In children-under light general anesthesia (with O2, N2O, Halothane).
3. Clean the lower back
4. Drape the part with sterile towels leaving the sacrococcygeal region exposed.
5. Tip of coccyx identified.
6. Triangular sacral hiatus palpated 3.5 to 5 cm above it (Local infiltration not given to preserve landmarks).
7. Five cm needle, 22 G is inserted through the sacrococcygeal membrane at an angle of 20° (no need to use epidural needle).
8. Once through the membrane, the needle is depressed to further 45° towards the intergluteal cleft and the needle is advanced further 2 to 3 cm in the midline. The needle should not go beyond the level of postsuperior iliac spine.
9. Ten ml syringe with air attached to the needle and test for loss of resistance and aspiration test done.
10. If no crepitus over the skin or no CSF, drug injected into the space after a test dose slowly
Any questions be sent to drmmkapur@gmail.com
All older posts are stored in archives for access and review.
Visitors that follow may post contributions to the site.
To create consumer/provider engagement visit www.surgseminar.blogspot.com
