Secondary spread of caudal block as assessed by ultrasonography

Lundblad, M.; Eksborg, Staffan; Lönnqvist, Per‐Arne

doi:10.1093/bja/aer513

Cited by 48 publications

(41 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…; Lundblad et al. ; Triffterer et al. ), and an unambiguous identification of epidural or intrathecal injection with the presence or absence of a color flow Doppler signal (Tsui et al.…”

Section: Introductionmentioning

confidence: 99%

Sonographic evaluation of epidural and intrathecal injections in cats

Otero

Verdier

Zaccagnini

et al. 2016

Veterinary Anaesthesia and Analgesia

View full text Add to dashboard Cite

“…; Lundblad et al. ; Triffterer et al. ), and an unambiguous identification of epidural or intrathecal injection with the presence or absence of a color flow Doppler signal (Tsui et al.…”

Section: Introductionmentioning

confidence: 99%

Sonographic evaluation of epidural and intrathecal injections in cats

Otero

Verdier

Zaccagnini

et al. 2016

Veterinary Anaesthesia and Analgesia

View full text Add to dashboard Cite

“…The compression and the reexpansion of the dural sac force the local anesthetic to travel further cranially leading to secondary spread. [9] We did not study secondary spread, as our main aim was just to see the primary spread sonographically. Furthermore, with the huge turnover of the cases, it was difficult to wait for us to study secondary spread.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

View full text Add to dashboard Cite

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.

show abstract

“…In addition to the effects of volume and density, the spread is higher in neonates and with faster rates of injection. Some progression of distribution also occurs with time after the block has been performed (Table ) .…”

Section: Internal Anatomymentioning

confidence: 99%

A review of the surface and internal anatomy of the caudal canal in children

Lees

Frawley

Taghavi

et al. 2014

Pediatric Anesthesia

View full text Add to dashboard Cite

The anatomy of the sacral hiatus and caudal canal is prone to significant variation, yet studies assessing this in the pediatric population remain limited. Awareness of the possible anatomical variations is critical to the safety and success of caudal epidural blocks, particularly when image guidance is not employed. This systematic review analyzes the available evidence on the clinical anatomy of the caudal canal in pediatric patients, emphasizing surface anatomy and internal anatomical variations. A literature search using three electronic databases and standard pediatric and anatomy reference texts was conducted yielding 24 primary and seven secondary English-language sources. Appreciating that our current landmark-guided approaches to the caudal canal are not well studied in the pediatric population is important for both clinicians and researchers.

show abstract

Secondary spread of caudal block as assessed by ultrasonography

Cited by 48 publications

References 12 publications

Sonographic evaluation of epidural and intrathecal injections in cats

Sonographic evaluation of epidural and intrathecal injections in cats

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

A review of the surface and internal anatomy of the caudal canal in children

Contact Info

Product

Resources

About