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

Nanjundaswamy, Nethra H; Nagappa, Saraswathi; Shridhara, Raghavendra Biligiri; Kalappa, Sandya

doi:10.4103/theiaforum.theiaforum_73_19

Cited by 3 publications

(5 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7 Ahiskalioglu A et al and Karaca et al demonstrated that the duration of procedure was similar between the two groups. 4,8 Erbüyünet al, Riaz et al, Nanjundaswamy et al observed a longer block performing time in group U compared to group C. 3,9,10 This finding was similar to our study. The increased time taken with USG block may be successfully cut short with more practice.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Ultrasound guided technique versus landmark technique for caudal epidural block in children: A randomized controlled study

Dhadwal

Bhure²,

Bhargava³

2022

IJCA

View full text Add to dashboard Cite

The aim of this study was to compare the two modalities of performing caudal block – ultrasonography guidance and conventional landmark technique in terms of time taken to perform the block, number of attempts to perform the block, block success at first puncture, haemodynamic changes and complications.: The study was conducted in Department of Anaesthesiology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur. It was a prospective randomized single blinded study.: This study was conducted in 62 grade ASA I and II patients of both sexes between age group of 2 - 8 years posted for elective surgeries below the level of umbilicus. Patients were randomized into 2 groups: Group C (Conventional technique) (n = 31) and group U (Ultrasound technique) (n=31) Caudal solution was prepared as Inj 0.2% Ropivacaine with Inj Fentanyl 2 mcg/kg with dosage according to Armitage formula, and was administered to both groups. The block performing time, the block success rate, the number of needle puncture, the success at first puncture and the complications were recorded. The analysis was 2 tailed and significance level was set at 0.05.: The mean block performance in group C was 39.3 ± 10.9 seconds while that of the Group U was 52.2 ± 11.4 seconds (P = 0.001). The time taken for identification of the caudal epidural space in Group C was 15.74 + 8.05 seconds while that of the Group U was 24.26 + 8.89 seconds (p = 0.0002). There was no significant difference noted in the number of attempts taken for the block in between both the groups. C group had a success rate of 61.29% in the first attempt while U group has a success rate of 90.32%. (p = 0.008). C group had a success rate of 83.87% while U group has a success rate of 100%. (p = 0.008). The only complication seen in the study was subcutaneous bulging which was seen significantly more in patients of C group compared to U group. Subcutaneous bulging was seen in 8 patients of C group and in 2 patients of U group. Despite the limitations in central neuraxial anesthesia we recommend the use of ultrasound since it reduces the complications and increases the success rate of first puncture in pediatric caudal injection.

show abstract

Section: Discussionsupporting

confidence: 91%

“…Studies report varying success rates with the use of ultrasound for caudal blocks in paediatric anaesthesia. 3 However, it is not freely available in our country which makes conventional landmark technique more popular. Hence we performed an observational study to compare the two techniques.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound guided technique versus landmark technique for caudal epidural block in children: A randomized controlled study

Dhadwal

Bhure²,

Bhargava³

2022

IJCA

View full text Add to dashboard Cite

show abstract

“…We included four out of five trials to compare time taken to perform the block, as trial by Nanjundaswamy et al 14 did not report the standard deviation values. Time for block performance was defined as the time from needle puncture to termination of drug administration in all of the studies except by Karaca et al 11 wherein they defined it from identification of anatomical structures to termination of drug administration.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 570 articles were obtained after electronic database searching. After removing duplicates and meeting the inclusion and exclusion criteria, a total of five studies [10][11][12][13][14] were included for the analysis. One RCT was not included as full-length article was not available in English.…”

Section: Re Sultsmentioning

confidence: 99%

See 1 more Smart Citation

Comparative evaluation of landmark technique and ultrasound‐guided caudal epidural injection in pediatric population: A systematic review and meta‐analysis

Jain

Hussain

Ayub

2021

Pediatric Anesthesia

View full text Add to dashboard Cite

Caudal epidural block is a common regional anesthesia technique for lower limb and infraumbilical surgeries in children. 1 It makes up to 40% of all regional anesthesia blocks and more than 90% of single injection and 25% of continuous catheter neuraxial blocks in the pediatric age group. 2 The caudal block is highly popular in children because of multiple reasons. Firstly, the epidural space is easy to access due to non-ossification of ligaments. The spread of local anesthetic may be facilitated by fluidity of epidural fat and loose attachment of fascia to nerves. 3 The chance of dural puncture is also decreased as the dural sac ends well above the site of the sacral

show abstract

Comparison of ultrasound-guided versus conventional technique for caudal block in paediatric patients

Gupta,

Agarwal,

Misra

2023

IJCA

View full text Add to dashboard Cite

Caudal blocks have been recommended for surgical procedures mainly below umbilicus. Their use has increased in paediatric cases as they are easy to perform with low complication rates. There have been reports of this technique being performed as a sole anaesthetic in children who may not be a suitable candidate for general anaesthesia. This study was conducted with an aim to compare the traditionally used landmark guided technique of caudal block with ultrasound-guided technique in terms of intra-operative analgesia, haemodynamic parameters, time required to perform block and demand for rescue analgesia.This prospective randomized comparative study was carried out in 68 paediatric patients divided in two study groups (Group C and Group U) undergoing elective lower gastrointestinal and genito-urinary tract surgeries over a period of two years in a tertiary care hospital.The intra-operative haemodynamic parameters were comparable in both the groups. There was a significant increase in time taken to perform the block in Group U as compared to Group C (6.5 minutes v/s 15 minutes) (p-value <0.001). The success rate at first puncture was 52.2% in Group C and 47.8% in Group U. The majority of patients were relaxed and comfortable in the 1st hour post-operatively. The requirement of rescue analgesia in the post-operative period was comparable in both the groups. The conventional technique is easier and less time consuming as compared to the ultrasound-guided technique, which is newer and the practitioner needs expertise. The quality of analgesia provided by both the techniques is comparable. The frequency of complications associated with the block are fewer with the ultrasound-guided approach. Ultrasonography is the modality of choice specially in cases where detection of sacral anatomy and landmarks is difficult. However, further studies are needed to establish the role of ultrasonography in performing caudal block.

show abstract

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

Cited by 3 publications

References 2 publications

Ultrasound guided technique versus landmark technique for caudal epidural block in children: A randomized controlled study

Ultrasound guided technique versus landmark technique for caudal epidural block in children: A randomized controlled study

Comparative evaluation of landmark technique and ultrasound‐guided caudal epidural injection in pediatric population: A systematic review and meta‐analysis

Comparison of ultrasound-guided versus conventional technique for caudal block in paediatric patients

Contact Info

Product

Resources

About