Related Experiment Video

Updated: May 21, 2026

Use of a Piglet Model for the Study of Anesthetic-induced Developmental Neurotoxicity (AIDN): A Translational Neuroscience Approach
06:38

Use of a Piglet Model for the Study of Anesthetic-induced Developmental Neurotoxicity (AIDN): A Translational Neuroscience Approach

Published on: June 11, 2017

[Pediatric caudal anesthesia : importance and aspects of safety concerns]

J Mauch1, M Weiss

  • 1Anästhesieabteilung, Universitäts-Kinderkliniken Zürich, Steinwiesstr. 75, 8032, Zürich, Schweiz. jacqueline.mauch@kispi.uzh.ch

Der Anaesthesist
|June 15, 2012
PubMed

Insights

Caudal blocks are safe for pediatric pain relief when technical details are followed. Using local anesthetic with epinephrine aids in detecting accidental intravascular injection, enhancing patient safety.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery

Background:

  • Caudal block is a widely used and generally safe procedure for pediatric perioperative analgesia.
  • While complications are rare, potential local and systemic contraindications must be carefully evaluated.
  • Adherence to technical details is crucial for optimizing safety and quality outcomes.

Purpose of the Study:

  • To review the technical details and safety considerations for performing caudal blocks in pediatric patients.
  • To highlight strategies for preventing and managing potential complications, such as inadvertent intravascular injection and systemic toxicity.

Main Methods:

  • Review of existing literature and guidelines on caudal block procedures in pediatrics.
  • Discussion of anesthetic agents, adjuvants, and technical aspects relevant to safety.
  • Emphasis on measures for prevention, early detection, and management of complications.

Main Results:

  • Local anesthetics (LA) with epinephrine are recommended for test doses to detect intravascular administration.
  • Clonidine demonstrates a favorable risk/benefit profile as an adjuvant with minimal side effects.
  • Systemic LA intoxication is a rare but potentially fatal complication requiring immediate resuscitation protocols.

Conclusions:

  • Meticulous attention to technical details is paramount for safe and effective pediatric caudal blocks.
  • Epinephrine-containing solutions are valuable for early detection of intravascular injection.
  • Standard resuscitation guidelines, including epinephrine, are essential in managing circulatory arrest, with lipid emulsions as a potential adjunct.

Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
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...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...