Comparison of Landmark-guided, Nerve Stimulation-guided, and Ultrasound-guided Techniques for Paediatric Caudal Epidural Anaesthesia

Objective: To assess the short-term efficacy of ultrasound-guided caudal epidural steroid injections (ESIs) in improving pain, and nerve function as measured by electrophysiological testing in chronic radicular low back pain. Methods: Patients diagnosed with chronic radicular low back pain were randomized into one of two groups. The injection group (n = 20) underwent a single ultrasound-guided Caudal ESI of 1 ml of 40 mg ml−1 Triamcinolone Acetonide (Kenacort-A), with local anesthetic. The control group (n = 20) underwent a 12-session physiotherapy program. Both groups were evaluated before and 2 weeks after the intervention using visual analog scale for pain and electrophysiological testing comprising peroneal and tibial terminal motor latencies and F-response latencies and chronodispersion. Results: Both groups showed significant pain reduction on the visual analog scale after the intervention. The injection group showed a significant reduction in F wave chronodispersion post-treatment (<0.01). In the control group, there were no significant differences in F wave parameters pre- and post-treatment (p > 0.05). Conclusion: Caudal ESIs were shown to provide short-term improvement of nerve function as evident by improvement in the electrophysiological parameters sensitive to radiculopathy. It was found to be superior to standard physical therapy in this regard. Advances in knowledge: This work shows a novel electrophysiologic evidence of the short-term efficacy ultrasound-guided caudal ESI.

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Ultrasound-guided Percutaneous Peripheral Nerve Stimulation for the Treatment of Complex Regional Pain Syndrome Type 1 Following a Crush Injury to the Fifth Digit: A Rare Case Report

Cureus ◽

10.7759/cureus.6506 ◽

2019 ◽

Author(s):

Ashley V Fritz ◽

Guilherme Ferreira-Dos-Santos ◽

Mark Friedrich Hurdle ◽

Steven Clendenen

Keyword(s):

Case Report ◽

Peripheral Nerve ◽

Complex Regional Pain Syndrome ◽

Nerve Stimulation ◽

Rare Case ◽

Pain Syndrome ◽

Syndrome Type ◽

Ultrasound Guided ◽

Rare Case Report

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Continuous caudal epidural anaesthesia for vaginal hysterectomy in a patient of heart disease and severe spinal deformity; a case report

journal of Anesthesiology and Clinical Science ◽

10.7243/2049-9752-2-15 ◽

2013 ◽

Vol 2 (1) ◽

pp. 15 ◽

Cited By ~ 1

Author(s):

Ashok Jadon ◽

Swastika Chakraborty ◽

Neelam Sinha ◽

Sunil Kedia

Keyword(s):

Heart Disease ◽

Case Report ◽

Spinal Deformity ◽

Epidural Anaesthesia ◽

Vaginal Hysterectomy ◽

Severe Spinal Deformity ◽

Caudal Epidural

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Ultrasound-Guided Caudal Epidural Injections

Atlas of Ultrasound-Guided Procedures in Interventional Pain Management ◽

10.1007/978-1-4939-7754-3_13 ◽

2018 ◽

pp. 145-149

Author(s):

Amaresh Vydyanathan ◽

Samer N. Narouze

Keyword(s):

Ultrasound Guided ◽

Epidural Injections ◽

Caudal Epidural

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Ultrasound-Guided Caudal Epidural Block for Bilateral Testicular Ectopy and Circumcision in Child above 6 Years with Joubert Syndrome

Journal of Pediatrics & Child Health Care ◽

10.26420/jpediatrchildhealthcare.2021.1040 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Fekih Hassen Amjed ◽

◽

Ben Fraj Asma ◽

Blaiti Hajer ◽

Ben Slimen Ahmed ◽

...

Keyword(s):

Respiratory Control ◽

Perioperative Period ◽

Joubert Syndrome ◽

Epidural Block ◽

Opioid Use ◽

Ultrasound Guided ◽

Polygraphic Recordings ◽

Caudal Epidural Block ◽

Anesthesia Technique ◽

Caudal Epidural

Background: Abnormal respiratory control has been clearly documented in infants and children with Joubert Syndrome (JS) by polygraphic recordings, characterized by episodes of apnea, tachypnea, and/or hyperpnea and the risk of recurrence of these episodes increase probably in perioperative period. In those cases, the choice of anesthesia technique and postoperative pain protocol, constitute a challenge for anesthesiologists. Case: We describe a case of successful ultrasound-guided Caudal Epidural Block (CEB) for children above 6 years with Joubert Syndrome undergoing bilateral testicular ectopy and circumcision avoiding opioid-use. Conclusions: Despite the difficulty to achieve CEB in child above 6 years, the ultrasound-guided can increase the success providing effective analgesia in-patient with a high-risk of respiratory failure as child with JS.

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