Rare complications of caudal block with review of literature

ABSTRACT

Caudal block has been used for many decades. [3] The purpose of using this technique has been either for anesthetic use or for managing the low back ache especially when there is adhesions or compression on the nerve roots. Complications of this technique are well-documented, they include[5] perforation of the rectum, hydrocele, infection, bleeding, loss of consciousness, cardiac arrhythmias, arrest, intravascular or intraosseous injection, urinary retention, subcutaneous injection, haematoma and absent or patchy block. We studied the case of a 36-year-old female who was found after her birth to be suffering from poliomyelitis at the right side. During her growth she was suffering from mild tolerable low back ache. Then, when she became 30 years old, her back ache got intolerable. MRI-scan and X-rays showed ascoliotic change at her lumbar area accompanied by epidural adhesions of the lumbar area, which caused her pain. A surgical consultation revealed no necessity for surgery at the time being. Therefore, conservative treatment was planned including caudal block by using a mixture of pupivacaine and steroids. During performing the caudal block, the patient was lying in aprone position, we started to inject 1.5 ml's of lignocaine [1%] in order to anesthetise the area which includes the subcutaneous tissue and sacro coxygeal ligament. After injecting 1 ml of lignocaine, patient lost her consciousness for about 15 minutes. All her hymodynamics and cardiac observations were normal. After gaining her conscious again, the procedure was carried out safely