Study Confirms Safeness of Caudal Blocks for Pediatric Surgery

Complication rate fewer than two percent for the regional anesthesia procedure

Caudal blocks safe for pediatric surgery

A new report found that caudal blocks are safe and effective for infants and children undergoing surgery.

A new report published in the October issue of Anesthesia & Analgesia shows that caudal nerve blocks, a common regional anesthesia procedure used in most pediatric surgeries, are safe and effective to use in infants and children, and carry with them very few complications and no lasting adverse effects. The study was done by Dr. Santhanam Suresh and colleagues at Northwestern University in Chicago.

According to the report, the estimated complication rate for caudal blocks was 1.9 percent, with the most common complications due to incorrect needle placement. Out of all the complications that were reported, none of them led to lasting or permanent adverse effects. Serious complications were extremely rare, occurring in only four out of the 18,650 cases used in the study.

“The current study is, to the best of our knowledge, the largest study to demonstrate safety of a single regional anesthesia technique in children,” wrote Dr. Suresh.

The data came from the Pediatric Regional Anesthesia Network (PRAN), a centralized database which collects information on practice patterns and complications of regional anesthesia techniques in children. Dr. Suresh and his colleagues analyzed the safety outcomes in 18,650 children who underwent surgery with a caudal block between 2007 and 2012. Caudal blocks were performed in 18 different children’s hospitals between the years used in the report, and according to researchers the procedure is, “likely the most common regional anesthesia technique performed in children.”

However, the report also showed a large variation in the dosage of local anesthetic used for caudal blocks. Around one-fourth of children received a dose that could cause potential toxic effects, and more studies will need to be done in order to find the optimal level of local anesthetic that should be used.

Previous studies on caudal blocks have only come from single hospitals, which made it difficult to examine the overall risks associated with the technique. The PRAN database collects data from a wide range of hospitals, making its use for this study crucial.

“This paper shows that caudal blocks for post-operative pain control are safe in children,” said Dr. Steven L. Shafer of Stanford University and Editor-in-Chief of Anesthesia & Analgesia. “It will help to guide physicians, and parents, in selecting the anesthetic that provides the best outcome for their kids.”

To read more about the new report, click here: Nerve Block Procedure is Safe in Children, Reports Anesthesia & Analgesia.


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