CAUDAL EPIDURAL BLOCK

Anatomy

The caudal area is located at the bottom of the spinal canal.  The spinal canal ends just above the buttocks. The needle is placed just above the gluteal fold.

Preparation for Caudal Injection

… Do not eat or drink 6 hours before your appointment time.  This is to prevent you from becoming nauseated and possibly vomiting as a reaction to some of the medications used.

… You must be accompanied by a person who can drive you home.  You will be given sedation, which alters your driving abilities, and you could injure or kill yourself or someone else if you drive.

… An IV, EKG, and blood pressure cuff will be placed on you.  Light sedation will be given through your IV.

… You will need to read and sign a consent form prior to being sedated. You will be positioned on the examining table either lying face down or on your side.

… The doctor will press on your lower back to find landmarks to place the needle.

… The area will be cleansed with a special soap.

… The needle will be placed and you might feel pressure as the medicine is injected.  The medicine contains an anesthetic and a steroid.

Indications for Having a Caudal Block

… Lower back pain

… Rectal pain

… Coccydynia (Tailbone pain)

… Leg pain

Benefits

The introduction of anesthetics into the epidural space reduces pain and inflammation around the nerve roots.

Possible Risks

The caudal block can be safely performed as an outpatient at the Pain Control Center.  However, certain complications may occur.  These are backache, inadvertent spinal block, nerve damage, convulsions, pain or neuroma at puncture site, urinary retention, respiratory and/or cardiac arrest.  Even though these complications are rare, resuscitative equipment as well as experienced doctors and nurse are always close by to handle these emergency situations.

Frequency of Treatment

Caudal injections are often repeated at two-week intervals for best effects.  Usually, this is done in conjunction with physical therapy.  A maximum of three blocks are performed per series.  This series can be repeated after 6-12 months should your doctor feel another series would be beneficial.

Things to Expect After a Block

… Your blood pressure may decline.  Usually your IV fluid intake will counteract this, but there are medications that can be used to keep it from dropping significantly.

… You may have numbness and weakness in your legs but this is temporary and will resolve in 4-6 hours.

… Some soreness at the needle puncture site can be expected.  Tylenol with a heating pad may be beneficial.

… Difficulty with urination - again this is temporary and will resolve in 4-6 hours.  If you are unable to empty your bladder after 6 hours, you should contact the Pain Control Center.

Things You Can Do to Aid in Your Care

… Get 8 hours of sleep at night.

… Eat 3 well-balanced meals.

… Avoid lifting heavy objects and use your legs when lifting anything.

… Use good posture.