Caudal anaesthesia: does it have a place today?

  • P. Busoni
Conference paper


Caudal anaesthesia is still probably the most-popular, most-used, and most-studied regional technique in children, neonates, and small infants. Undoubtedly a large body of experience exists for this techniques [1, 2]. As with any other technique, caudal blocks are not without risks, and obviously in choosing an anaesthetic method advantages and disadvantages should be carefully evaluated. Several questions arise: what are the risks, what are the advantages in doing a caudal block in a child? Which are the alternative options and are they safer?


Nerve Block Pyloric Stenosis Central Block Peripheral Nerve Block Caudal Block 
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  1. 1.
    Giaufre E, Dalens B, Gombert A (1966) Epidemiology and morbility of regional anesthesia in children: a one year prospective survey of the French-language society of pediatric anesthesiologists. Anesth Analg 83:904–912Google Scholar
  2. 2.
    Dalens B, Hasnaoui A (1989) Caudal anesthesia in pediatric surgery: success rate and adverse effects in 750 consecutive patients. Anesth Analg 68:83–89PubMedCrossRefGoogle Scholar
  3. 3.
    Busoni P, Andreuccetti T (1986) The spread of caudal analgesia in children: a mathematical model. Anaesth Intensive Care 14: 140–144PubMedGoogle Scholar
  4. 4.
    Armitage EN (1979) Caudal block in children. Anaesthesia 34:396–396Google Scholar
  5. 5.
    Armitage EN (1985) Regional anesthesia in paediatrics. Clin Anaesthesiol 3:553–568Google Scholar
  6. 6.
    Arthur DS, McNicol LR (1986) Local anaesthetic techniques in paediatric surgery. Br J Anaesth 58:760–777PubMedCrossRefGoogle Scholar
  7. 7.
    Spear RM, Desphande JK, Maxwell LG (1988) Caudal anaesthesia in the high-risk infant. Anesthesiology 69:407–409PubMedCrossRefGoogle Scholar
  8. 8.
    Moyao-Garcia D, Garza-Leyva M, Velazquez-Armenta EY et al (2002) Caudal block with 4mg-kgl (1.6 ml/kg 1) of bupivacaine 0.25% in children undergoing surgical correction of congenital pyloric stenosis. Paediatr Anaesth 12:404–407PubMedCrossRefGoogle Scholar
  9. 9.
    Bosemberg AT, Bland BAR, Schulte-Steinberg O, Downing JW (1989) Thoracic epidural anesthesia via caudal route in infants Anesthesiology 69:265–269Google Scholar
  10. 10.
    Dohi S, Naito H, Takahashi T (1979) Age-related changes in blood pressure and duration of motor block in spinal anesthesia. Anesthesiology 50:319–323PubMedCrossRefGoogle Scholar
  11. 11.
    Larousse E, Asehnoune K, Dartayet B, et al (2002) The hemodynamic effects of pediatric caudal anesthesia assessed by esophageal Doppler. Anesth Analg 94:1165–1168PubMedCrossRefGoogle Scholar
  12. 12.
    Uguralp S, Mutus M, Koroglu A, et al (2002) Regional anesthesia is a good alternative to general anesthesia in pediatric surgery: experience in 1,554 children. J Pediatr Surg 37:610–613PubMedCrossRefGoogle Scholar
  13. 13.
    Flandin-Blety C, Barrier G (1995) Accidents following extradural alagesia in children. The results of a retrospective study. Paediatr Anaesth 5:41–46PubMedCrossRefGoogle Scholar
  14. 14.
    Giaufre E, Dalens B, Gombert A (1996) Epidemiology and morbidity of regional anesthesia in children – A one-year prospective survey of the French-Language Society of Pediatric Anesthesiologists (ADARPEF). Anesth Analg 83:904–912PubMedGoogle Scholar
  15. 15.
    Taras JS, Behrman MJ (1998) Continuous peripheral nerve block in replantation and revascularization. J Reconstr Microsurg 14:17–21PubMedCrossRefGoogle Scholar
  16. 16.
    Sutherland ID (1998) Continuous sciatic nerve infusion: expanded case report describing a new approach. Reg Anesth Pam Med 23:496–501Google Scholar
  17. 17.
    Longo SR, Williams DP (1977) Bilateral fascia iliaca catheters for postoperative pain control after bilateral total knee arthroplasty: a case report and description of a catheter technique. Reg Anesth 22:372–377CrossRefGoogle Scholar
  18. 18.
    Paut O, Sallabery M, Schreiber-Deturmeny E, et al (2001) Continuous fasci ihaca compartment block in children: a prospective evaluation of plasma bupivacaine concentrations, pain scores, and side effects J Anesth Analg 92:1159–1163Google Scholar
  19. 19.
    Carr DB (1998) Preempting the memory of pain. JAMA 279:114–115CrossRefGoogle Scholar
  20. 20.
    Niv D, Devor M (1998) Transition from acute to chronic pain. In:Aronoff GM (ed) Evaluation and treatment of chronic pain, 3rd edn William and Wilkins, BaltimoreGoogle Scholar
  21. 21.
    Besson JM (1999) The neurobiology of pain. Lancet 353:1610–1615PubMedCrossRefGoogle Scholar
  22. 22.
    Basbaum AI (1999) Spinal mechanism of acute and persistent pain. Reg Anesth Pain Med 24:56–67Google Scholar
  23. 23.
    Albright AL, Barron WB, Fasick MP, et al (1993) Continuous intrathecal baclofen for infusion for spasticity of cerebral origin. JAMA 270:2475–2477PubMedCrossRefGoogle Scholar
  24. 24.
    Omote K, Kawamata M, Satoh O, et al (1996) Spinal antinociceptive action of an N-type voltage-dependent calcium blocker and the synergistic interaction with morphine. Anesthesiology 84:636–643PubMedCrossRefGoogle Scholar
  25. 25.
    Eisenach JC, Gebhart GF (1995) Intrathecal amitriptyline-antinociceptive interaction with intravenous morphine and intrathecal cloidine, neostigmine, and carbamylcholine in rats. Anesthesiology 83:1046–1054PubMedCrossRefGoogle Scholar
  26. 26.
    Hood DD, Eisenach JC, Tuttle R (1995) Phase 1 safety assessment of intrathecal neostigmine methylsulfate in humans. Anesthesiology 82:331–343PubMedCrossRefGoogle Scholar
  27. 27.
    Kristensen JD, Svensson B, Gordh T (1992) The NMDA-receptor antagonist CPP abolishes neurogenic ‘wind up pain’ after intrathecal administration in humans. Pain 51:249–253PubMedCrossRefGoogle Scholar
  28. 28.
    Yang CY, Wong CS, Chang JY et al (1992) Intrathecal ketamine reduces morphine requirements in patients with terminal cancer pain; a controlled comparison with epidural steroid in a pilot study. Pain 48:5–12CrossRefGoogle Scholar

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© Springer-Verlag Italia 2003

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  • P. Busoni

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