The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.
What should I do and expect after the procedure?
You may have some partial numbness in your buttocks and/or legs from the anesthetic after the injection. This may last several hours but you will be able to function safely as long as you take precautions. You will report your remaining pain (if any) and also record the relief you experience over the next week in a âpain diaryâ which we will provide. *Mail or fax the completed pain diary in the envelope provided, so that your treating physician can be informed of your results and plan future tests and/or treatment if needed.
Caudal epidural steroid injections involve injecting a steroid into the epidural space, where the irritated nerve roots are located. The caudal injection is performed through the sacral opening and is used to treat low back pain. This injection includes both a long-lasting steroid and an anesthetic (lidocaine, bupivacaine). The steroid reduces inflammation and irritation, while the anesthetic interrupts the pain-spasm cycle and nociceptor transmission (Boswell 2007). The medicines spread to the most painful levels of the spine, reducing inflammation and irritation. The entire procedure usually takes less than 15 minutes.