Caudal Block
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13 terms
Terms | Definitions |
|---|---|
 Why is the caudal opening of the spinal canal present? | Failure of the 5th pair of laminae to meet |
| where do the 5th spinal nerves emerge? | through the hiatus medial to the sacral cornua |
| where can the epidural venous plexus be found inside the sacral canal? | they are located in the anterolateral portion all the way until S4 |
| Why is there a decrease in predictability of level of anesthesia with caudal approach with increasing age? | the opening of the sacral hiatus may be closed, but most importantly there is a decrease in the amount of adipose tissue found in the sacral hiatus |
| what are the 3 basic steps to performing a caudal epidural block? | palpitation, identification, and puncture |
| what position are adults placed in for caudal? | placed primarily in the prone position |
| what position are peds placed in for caudal? | placed in lateral decubitus position |
| what is a caudal block useful? | for chronic pain in adults. surgeries involving the sacral segment, ie clubfoot repair, circ, hypospadias repair, or rectal surgery |
| Is there more of a sensory, motor, or combined anesthesia? | there is more of a sensory blockade |
| what size needle is used for caudual block | 2.5cm long, 23g |
| what is the insertion, penetration, and advancement technique for caudal block | Insert the needle midline at 60 degree angle to the coronal plane. Penetration of the sacrococcygeal membrane is acheived with a loss of resistance (pop). Needle is lowere to 20 degree angle and advanced 2-3mm to make sure that bevel is in the caudal space |
| where is the dura usually located in the sacrum? | around the level of S2, |
| what dose of anesthetic is appropriate for sacral blockade in peds? | Bupivacaine 0.25% 0.5ml/kg |
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