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BioMed Research International
Volume 2017, Article ID 9217145, 5 pages
https://doi.org/10.1155/2017/9217145
Review Article

Caudal Epidural Block: An Updated Review of Anatomy and Techniques

Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan

Correspondence should be addressed to Chia-Shiang Lin; moc.liamg@nilscnaes

Received 17 October 2016; Revised 17 December 2016; Accepted 7 February 2017; Published 26 February 2017

Academic Editor: Yasuyuki Shibata

Copyright © 2017 Sheng-Chin Kao and Chia-Shiang Lin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Caudal epidural block is a commonly used technique for surgical anesthesia in children and chronic pain management in adults. It is performed by inserting a needle through the sacral hiatus to gain entrance into the sacral epidural space. Using conventional blind technique, the failure rate of caudal epidural block in adults is high even in experienced hands. This high failure rate could be attributed to anatomic variations that make locating sacral hiatus difficult. With the advent of fluoroscopy and ultrasound in guiding needle placement, the success rate of caudal epidural block has been markedly improved. Although fluoroscopy is still considered the gold standard when performing caudal epidural injection, ultrasonography has been demonstrated to be highly effective in accurately guiding the needle entering the caudal epidural space and produce comparative treatment outcome as fluoroscopy. Except intravascular and intrathecal injection, ultrasonography could be as effective as fluoroscopy in preventing complications during caudal epidural injection. The relevant anatomy and techniques in performing the caudal epidural block will be briefly reviewed in this article.