Term
| What are the three landmarks used to triangulate the location of the sacral hiatus for a caudal block? |
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Definition
[image]
The left and right cornu (base of upside down triangle) and the coccyx. The sacral hiatus is found within this triangle, cephaled to the xiphoid process. |
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Term
| At what angle should you insert your needle when attempting a caudal block (through the sacral hiatus)? |
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Definition
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Term
| The loss of resistance or "pop" felt when performing a caudal block indicates penetration through what structure? |
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Definition
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Term
| After feeling the sacrococcygeal ligament "pop" while attempting a caudal block what should your next step be? |
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Definition
"When you feel that pop, you gots to drop!"
- Drop your needle down to align it with the plane of the sacral canal.
- Insert the needle an additional 1 cm.
- Inject 2cc of air.
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Term
| After you assume you've entered the sacral canal while performing a caudal block and have injected 2cc of air to test your location, what should you feel next? |
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Definition
You should feel the space BULGE.
If you feel crepitus you're in the wrong place.
The next step would be to aspirate. If you aspirate CSF or blood, you're in the wrong place. |
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Term
| How do you dose caudal block solution volumes for infants and children (solution volume per kg)? |
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Definition
| 0.5 - 1ml of solution/kg body weight |
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Term
What's the most common specific drug solution concentration given to infants and kids for a caudal block?
How high of a block will this dosing pattern typically give you? |
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Definition
0.125% to 0.5% Bupivicaine with epi 1/200,000
(Gayle listed Ropivicaine and Lidocaine as well but did not give specific concentrations).
This dosing pattern (o.5-1 ml/kg with the above drug) will typically block to the umbilicus. |
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