Caudal Anaesthesia for Upper Abdominal Surgery in Infants and Children: A Simple Calculation of the Volume of Local Anaesthetic

Satoyoshi, M; Kamiyama, Yoichiro

doi:10.1111/j.1399-6576.1984.tb02011.x

Cited by 26 publications

(20 citation statements)

References 5 publications

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“…It is know that a number of factors, including weight, influence the spread of caudal solutions, and mathematical formulae using weight, age, and height have been devised to predict the correct volume. Satayoshi and Kamiyama (10) suggest that the distance from C7 to the sacral hiatus in cm ( D ) is related to the desired volume ( V ) to clinically block to T4 by the formula V = D − 13. Weight was found to be a greater predictor of spread of analgesia in very young patients having caudals, whereas age was a better guide in older children in the study by Busoni and Andreuccetti (8) on 763 children.…”

Section: Discussionmentioning

confidence: 99%

The effect of volume of local anesthetic on the anatomic spread of caudal block in children aged 1-7 years

Thomas¹,

Roebuck

Yule³

et al. 2010

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 99%

The effect of volume of local anesthetic on the anatomic spread of caudal block in children aged 1-7 years

Thomas¹,

Roebuck

Yule³

et al. 2010

Pediatric Anesthesia

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“…This calculation yielded fairly good results in children between the age group 1 month to 11 years undergoing abdominal surgeries. [7] They did not take weight into calculation, as many patients were underweight for their height.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound assessment of cranial spread during caudal blockade in children: Effect of different volumes of local anesthetic

et al. 2017

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Background:Ultrasound-guided caudal block injection is a simple, safe, and effective method of anesthesia/analgesia in pediatric patients. The volume of caudal drug required has always been a matter of debate.Materials and Methods:This present prospective, randomized, double-blinded study aimed to measure extent of the cranial spread of caudally administered levobupivacaine in Indian children by means of real-time ultrasonography. Ninety American Society of Anesthesiologists I/II children scheduled for urogenital surgeries were enrolled in this trial. Anesthesia and caudal analgesia were administered in a standardized manner in the patients. The patients received 0.5 ml/kg or 1 ml/kg or 1.25 ml/kg of 0.125% levobupivacaine according to the group allocated. Cranial spread of local anesthetic was noted using ultrasound.Results:There was no difference in the spread when related to age, sex, weight, or body mass index. A significant difference of ultrasound-assessed cranial spread of the local anesthetic was found between Group 1 (0.5 ml/kg) with both Group 2 (1 ml/kg) (P = 0.001) and with Group 3 (1.125 ml/kg) (P < 0.001) but there is no significant difference between Group 2 and Group 3 (P = 0.451) revealing that spinal level spread is only different between 0.5 ml/kg and 1 ml/kg of local anesthetic.Conclusion:In conclusion, the ultrasound assessment of local anesthetic spread after a caudal block showed that cranial spread of the block is dependent on the volume injected into the caudal space. Since there was no difference between 1 ml/kg and 1.25 ml/kg, to achieve a dermatomal blockade up to thoracic level, we might have to increase the dose beyond 1.25 ml/kg, keeping the toxic dose in mind.

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“…[18–20] The height of the dermatomal level depends on the volume of the medication administered while the density of the block depends on the concentration of the local anesthetic. In children, a commonly used regimen is 1 mL/kg of 0.25% bupivacaine with 1:200,000 epinephrine which typically produces analgesia to the T6-8 level.…”

Section: Discussionmentioning

confidence: 99%

Caudal epidural blockade in adolescents

et al. 2013

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Background:Various options are available for the provision of analgesia following major surgical procedures including systemic opioids and regional anesthetic techniques. Regional anesthetic techniques offer the advantage of providing analgesia while avoiding the deleterious adverse effects associated with opioids including nausea, vomiting, sedation and respiratory depression. Although used commonly in infants and children, there is a paucity of experience with the use of caudal epidural blockade in adolescents.Methods:We retrospectively reviewed the perioperative care of adolescents undergoing major urologic or orthopedic surgical procedures for whom a caudal epidural block was placed for postoperative analgesia.Results:The cohort for the study included 5 adolescents, ranging in age from 13 to 18 years and in weight from 42 to 71 kilograms. Caudal epidural analgesia was accomplished after the induction of anesthesia and prior to the start of the surgical procedure using 20-25 mL of either 0.25% bupivacaine or 0.2% ropivacaine with clonidine (1 μg/kg). The patients denied pain the recovery room. The time to first request for analgesia varied from 12 to 18 hours with the patients requiring 1-3 doses of analgesic agents during the initial 24 postoperative hours.Conclusions:Our preliminary experience demonstrates the efficacy of caudal epidural block in providing analgesia following major urologic and orthopedic surgical procedures. The applications of this technique as a means of providing postoperative analgesia are discussed.

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Caudal Anaesthesia for Upper Abdominal Surgery in Infants and Children: A Simple Calculation of the Volume of Local Anaesthetic

Cited by 26 publications

References 5 publications

The effect of volume of local anesthetic on the anatomic spread of caudal block in children aged 1-7 years

The effect of volume of local anesthetic on the anatomic spread of caudal block in children aged 1-7 years

Ultrasound assessment of cranial spread during caudal blockade in children: Effect of different volumes of local anesthetic

Caudal epidural blockade in adolescents

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