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Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
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Ultrasound-guided versus conventional injection for caudal block in children: A prospective randomized clinical study

Ali Ahiskalioglu1, Ahmet Murat Yayik2, Elif Oral Ahiskalioglu2

  • 1Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.

Journal of Clinical Anesthesia
|November 22, 2017
PubMed

Insights

Ultrasound guidance for pediatric caudal blocks improves first-attempt success and reduces complications like vascular puncture. This technique enhances safety and efficacy in children undergoing surgery.

Area of Science:

  • Pediatric Anesthesiology
  • Regional Anesthesia
  • Medical Imaging

Background:

  • Caudal blocks are common for pediatric pain management.
  • Conventional caudal injection relies on anatomical landmarks.
  • Ultrasound guidance offers real-time visualization during needle insertion.

Purpose of the Study:

  • To compare the efficacy of ultrasound-guided sacral hiatus injection versus conventional sacral canal injection for caudal blocks in children.
  • To evaluate procedural success, complications, and needle placement accuracy.

Main Methods:

  • A randomized controlled trial involving 134 children (ages 5-12) undergoing elective surgery.
  • Children received caudal blocks using either ultrasound guidance (Group U) or conventional landmark technique (Group C).
  • Both groups received 0.125% levobupivacaine with morphine.

Main Results:

  • Block performance time and success rates were similar between groups (p>0.05).
  • Ultrasound guidance significantly increased the first puncture success rate (80% vs 63%, p=0.026).
  • Vascular puncture and subcutaneous bulging rates were significantly lower with ultrasound guidance (p<0.05).

Conclusions:

  • Ultrasound guidance is recommended for pediatric caudal injections.
  • It enhances the success rate of the first puncture.
  • It reduces the incidence of complications such as vascular puncture.
Abstract

Keywords:
Sacral canalSacral hiatusUltrasound guided caudal injection

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