Comparision Of Success Rate Of Ultrasound-Guided Versus Landmark Technique For Caudal Block In Children

Year : 2025 | Volume : 14 | Issue : 03 | Page : 1 10
    By

    Prabhakar Dahal,

  • Ravi Ram Shrestha,

  • Anuj Jung Karki,

  1. MBBS & MD, Department of Anaesthesia and Critical Care, University Hospital of North Tees, Hardwick Road, Stockton on Tees, United Kingdom
  2. Chief Consultant, Department of Anaesthesia and Critical Care National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
  3. Senior Consultant, Department of Anaesthesia and Critical Care and Pain Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal

Abstract

Background: Caudal block is one of the most widely used epidural techniques in children, and this study compares its success when performed using ultrasound guidance versus the traditional landmark method. Methods: Forty-six children aged seven years or younger, classified as ASA I–II and undergoing surgery under general anesthesia with caudal analgesia, were enrolled and randomly assigned to either the landmark group (Group C, n = 23) or the ultrasound group (Group U, n = 23). Demographics, overall success rate, first-attempt success, number of needle punctures, time to achieve a successful block, and complications – such as dural puncture, vascular puncture, and subcutaneous bulge – were recorded and compared. Results: Both groups were demographically similar. First-attempt success was significantly higher with ultrasound (82.6%) than with the landmark technique (47.83%). Overall success rates were comparable between groups (91.30% in Group C vs. 95.65% in Group U). The time required to achieve a successful block was also similar. Vascular puncture and subcutaneous bulge occurred slightly more often in the landmark group, though the differences were not statistically significant. No dural punctures occurred in either group. Conclusion: In children aged 0–7 years, ultrasound guidance improves firstattempt success for caudal epidural blocks, while overall success, procedure time, number of punctures, and complication rates remain similar to the landmark technique.

Keywords: Caudal epidural, ultrasound guided caudal block, landmark technique for caudal block.

[This article belongs to Research and Reviews : A Journal of Medical Science and Technology ]

How to cite this article:
Prabhakar Dahal, Ravi Ram Shrestha, Anuj Jung Karki. Comparision Of Success Rate Of Ultrasound-Guided Versus Landmark Technique For Caudal Block In Children. Research and Reviews : A Journal of Medical Science and Technology. 2025; 14(03):1-10.
How to cite this URL:
Prabhakar Dahal, Ravi Ram Shrestha, Anuj Jung Karki. Comparision Of Success Rate Of Ultrasound-Guided Versus Landmark Technique For Caudal Block In Children. Research and Reviews : A Journal of Medical Science and Technology. 2025; 14(03):1-10. Available from: https://journals.stmjournals.com/rrjomst/article=2025/view=233637


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Regular Issue Subscription Original Research
Volume 14
Issue 03
Received 01/12/2025
Accepted 05/12/2025
Published 08/12/2025
Publication Time 7 Days
143

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