Background: The aim of present study was to know the success rate of anatomical landmark based caudal epidural block, confirmed by fluoroscopy.
Materials and methods: Four hundred and twenty one patients aged 30-70 years, which were scheduled to go for interventional caudal epidural block for chronic back pain, were selected for study. Caudal block was administered based on anatomical landmarks and needle position was confirmed by fluoroscopy and contrast. Patients were placed in prone position, bilateral posterior superior iliac spine; sacral cornua and hiatus were identified by palpation. The primary objective was to know the success rate of anatomical landmark based epidural caudal block and the secondary objectives were to compare the first attempt success rate and complications like blood tap, dural puncture or other complications.
Results: Visibility of anatomical landmarks was easy in 80.50% patient and difficult in 19.50% patients. Palpability of cornua was easy in 84% of patients and difficult in 16% of patients. The success rate of anatomical landmark based caudal epidural block was 78.5% confirmed by fluoroscopy and contrast. The first attempt success rate was in 65.5%, 34.5% patients need more than one attempt for landmark based caudal epidural block. Blood tap was seen in 10.4% patients and in 4% patient’s needle was intravenous when contrast was given without showing blood tap.
Conclusion: Landmark based technique caudal block technique is still useful where ultrasound or fluoroscopy facilities are not available.
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