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A caudal block, also known as a caudal epidural block, the caudal block technique, or a block caudal, is a method of providing anesthesia that is generally used for pediatrics. This anesthesia method is used for pain relief and to provide numbness below the umbilicus, or belly button. It can be used alone or with other types of anesthesia. It is used to completely block out nerve sensation, so that the patient is completely relieved of the possibility of pain.
The caudal canal is the sacral part of the spinal canal near the lower spine. A caudal block is given by injection into the caudal canal. It is often used to decrease pain and discomfort following groin surgery or any surgery on the lower abdomen. The patient will be given another form of pain medication to treat discomfort after the caudal block has worn off.
Drugs that can be given in the caudal injection include lignocaine 1% and bupivacaine 0.25%. These drugs that are used for epidural caudals should come from single dose ampoules. For children, the dose is calculated with the age and weight. For adults, a caudal block is dosed at around 20 to 30 ml for an abdomen block and 15 to 20 ml for lower limb blocks.
These IV drugs are carefully monitored, as an overdose can be fatal. Recommended dosages hit a maximum of 2 mg/kg for bupivicaine and 4 mg/kg for lignocaine. If the dose hits a vein intravenously, it can reach toxicity at a much smaller dosage amount.
After a patient receives a caudal block, he will slowly regain sensation within 4 hours to 6 hours. The patient may be unstable due to the loss of sensation and should not try walking without assistance until full sensation has returned. Most patients are unlikely to have good balance or use of their legs and feet until about 6 hours after the procedure. Hot items should also be avoided, because this lack of sensation could cause the patient to accidental burn himself.
Medical professionals should be alerted if the caudal nerve block has caused the patient to suffer discomfort that is not tolerable with other pain medications. The patient should also be able to urinate at least every 8 hours after a caudal block is administered. Discomfort and inability to urinate may be signs that something is wrong and needs urgent attention.
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