Abstract

The use of ultrasound in regional anaesthesia is being increasingly used in adult and paediatric patients recently. Chances of bony ossification in children are less as compared to adults. Ultrasound imaging helps to delineate sacral and caudal anatomy. It also helps in guiding of caudal needle insertion and to visualize the caudal injectate. Hence ultrasound serves as an important tool in caudal epidural blocks specially in children. After obtaining the approval of ethical committee and parental written informed consent, a total of 70 children undergoing elective lower abdominal surgeries under caudal epidural anaesthesia were included in the study. After having met inclusion and exclusion criteria, patients were randomized based on computer generated randomization table into one of the two groups. Group A-Caudal block by traditional method and whoosh test. Group B-Caudal block using ultrasound. In our study, percentage of successful blocks were comparable in group A (31 of 35) and group B (35 of 35) and the difference was statistically nonsignificant (p= 0.12). In the present study motor response after block was seen in only 4 patients in group A while none in group B and hence the difference was statistically nonsignificant (p<0.122). In the present study, the first puncture success rate was higher in Group B (33 of 35 patients) as compared to Group A (10 of 35 patients) and the difference was statistically significant (p value <0.0001). Second attempt was required in 20 of 35 patients in Group A as compared to 2 of 35 patients in Group B. In group A, 5 patients required third attempt while none in Group B required more than two attempts.

Description