Caudal Block Procedure

Patient Selection and Indications

• Caudal blocks are most appropriate for infants and toddlers, while lumbar epidural approaches are preferred for older children 1, 2

Procedural Technique

• Long-acting local anesthetic (with or without adjuncts) is used for the caudal block 1
• Ultrasound machine with high-frequency linear probe is recommended for the procedure 1, 2
• Sterile preparation materials are necessary for the procedure 1
• The area should be prepared with antiseptic solution before the procedure 2
• Visualization of the sacral hiatus and surrounding structures using ultrasound is recommended 1, 2
• Confirmation of proper needle placement is crucial, with no blood return on aspiration 2 and no cerebrospinal fluid return 1
• Injection of the calculated dose of long-acting local anesthetic (with or without adjuncts like clonidine) is performed 1, 2

Medication Selection and Dosing

• Long-acting local anesthetics are preferred, with optional adjuncts like clonidine (improves block quality and duration) 1, 2 and morphine (for prolonged postoperative analgesia) 1, 2
• Dexamethasone or methylprednisolone may be considered to reduce postoperative swelling 1, 2