Caudal block in pediatrics

: Caudal block is the single most popular regional anesthetic technique used in infants and children. A review of the literature concerning complications related to this technique reveals that it is safe and it has a low failure rate. Probably the incidence of complications of caudal block is 7/10.000, the lowest of all the central blocks. High success rates in performing caudals in children are achieved after a lower caseload than for other regional anesthetic procedures. The success rate in children under 7 years of age is 99%, but most failures occur in the oldest. Caudal anaesthesia can be used for anything surgical under the umbilicus and is an acceptable alternative to general or spinal anaesthesia in premature and high-risk infants, where a regional anaesthesia alone may be preferable. Caudal morphine has been used successfully for postoperative analgesia in children of all ages, including neonates after open-heart surgery. Possible complications of this technique are: local anesthetics overdose, vascular penetration and intravascular injection of local anesthetics, dural puncture and total spinal anaesthesia, intraosseous injection, infections, meningitis, respiratory depression (when morphine is used). Authors analyze all these complications and the safety rules for their prevention.