Effectiveness of Caudal Epidural Block for Minor Gynaecological Procedures in Day Care Surgery.

Corresponding Author:
Dr. Raj Sekhar Sarkar,
340/1, Banamali Banerjee Road,
Haridebpur, Kolkata-700082,
West Bengal, India.
E-mail: dr_rajsekhar@yahoo.in

ABSTRACT

BACKGROUND

It is a well-known fact that caudal epidural block is effective in delivering paediatric analgesia, but the data regarding its usefulness for sacral analgesia and anaesthesia in adult patients is scarce. In this study, it is applied in teenage and adult patients in obstetric and gynaecological minor surgical procedures.

METHODS

179 female patients of ASA 1 and 2 of age group 11-70 yrs. undergoing minor gynaecological procedures were selected for this study. After pre anaesthetic check-up each patient was given 20 ml of 1.5% Lignocaine with Adrenaline (1:200000) in caudal epidural space. The effectiveness of caudal epidural block was studied in terms of type and duration of surgery, sensory level of analgesia, success rate, use of rescue analgesics and postoperative complications during PACU stay.

RESULTS

The result of this study is overwhelming. The success rate is 97.21%, only 5 patients required rescue analgesia with 2.79% failure rate. Average duration of anaesthesia and surgery were 36.4 mins and 22 mins respectively. Highest sensory level reached below T1W. Hypotension (6.14%), retention of urine (4.46%), persistent weak/heavy legs (3.91%), sedative requirement (10.05%),infection (1.11%) and sacral hematoma (0.55%) were among the side effects. 6.14% of patients had >2 hrs. stay at recovery. It was observed that caudal analgesia is effective for minor gynaecological and obstetric procedures with no significant failure rate, complications and no fatality.

CONCLUSIONS

Caudal epidural block is an alternate and simple procedure when compared to SAB/TIVA for MGP with high success rate and lesser side effects with decreased duration of PACU stay. Caudal epidural block is not only effective in paediatric patients but also in teens and adults for minor perineal procedures.

KEY WORDS

Caudal, Epidural, Analgesia, Sacrococcygeal