Related Experiment Video
Updated: Jul 14, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
Local anesthetic infiltration versus caudal epidural block for anorectal surgery: a randomized controlled trial
Zafar I Siddiqui1, William T Denman, Roman Schumann
1Department of Anesthesia, Tufts-New England Medical Center and Tufts University School of Medicine, Box 298, Boston, MA 02111, USA.
Study Objective:
To compare patient satisfaction with local anesthetic infiltration versus caudal epidural block for anorectal procedures.
Design:
Randomized controlled trial.
Setting:
Operating room and postanesthesia care unit (PACU).
Patients:
22 adult, ASA physical status I, II, and III patients scheduled for anorectal surgery.
Interventions:
Patients were randomized to receive either local anesthetic infiltration (LAI) (n = 10) by the surgeon or caudal epidural block (CEB) (n = 12) by the anesthesiologist.
Measurements:
The primary outcome was patient satisfaction with the anesthetic technique and pain relief 12 hours after the procedure on a 4-point Likert scale. Secondary outcomes included time to first analgesic request, time to reach a PACU discharge score (REACT score) of 10, time to ambulation, time to discharge home, and adverse events.
Main Results:
More subjects in the CEB group (83.3%) were highly satisfied than in the LAI group (20%; P = 0.003), assessed 12 hours postoperatively by telephone interview. Subjects in the CEB group requested analgesia 423 minutes later (95% confidence interval, 286-560 min) than subjects in the LAI group. Differences in time to reach a REACT score of 10, time to ambulation, and time to discharge home were not statistically significant.
Conclusions:
Caudal epidural block provides higher patient satisfaction and longer lasting analgesia than LAI without delaying discharge.
Related Concept Videos
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Spinal Anesthesia
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
Local Anesthetics: Differential Sensitivity of Nerve Fibers
Local Anesthetics: Chemistry and Structure-Activity Relationship
