Caudal Block

Published on 06/02/2015 by admin

Filed under Anesthesiology

Last modified 06/02/2015

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42 Caudal Block

Placement

Anatomy

Anatomy pertinent to caudal anesthesia centers on the sacral hiatus (Fig. 42-1). This can be most effectively localized by finding the posterior superior iliac spines bilaterally, drawing a line to join them, and then completing an equilateral triangle caudad. The tip of the equilateral triangle will overlie the sacral hiatus (Fig. 42-2). The caudal tip of the triangle will rest near the sacral cornua, which are unfused remnants of the spinous processes of the fifth sacral vertebra. Overlying the sacral hiatus is a fibroelastic membrane, which is the functional counterpart of the ligamentum flavum. Perhaps more than with any other sex difference found in regional anesthesia, the sacrum is distinctly different in men and women. In men, the cavity of the sacrum has a smooth curve from S1 to S5. Conversely, in women the sacrum is quite flat from S1 to S3, with a more pronounced curve in the S4 to S5 region (Fig. 42-3).

Position

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