Caudal anaesthesia

It is a local anaesthetic used for infiltration, peridural, nerve block, and caudal anaesthesia. It is found to be twiee as potent as procaine. It has been reported that its duration of action is significantly longer than that of lidocaine, even without adrenaline. Henee, it is of particular importance in subjects showing contraindication to adrenaline. 

Foetal depression during spinal and epidural obstetric anaesthesia occurs secondary to maternal hypotension or as a result of placental transfer of the local anaesthetic agent (8, 10 -, 13 ). In this respect, bupivacaine was found to have a low foeto-maternal drug concentration ratio (16 -). When caudal anaesthesia is used, direct injection of the local anaesthetic drug into the foetus is possible (13, Other causes... 

Extradural (epidural) anaesthesia is used in the thoracic, lumbar and sacral (caudal) regions. Lumbar epidurals are used widely in obstetrics and low thoracic epidurals provide excellent analgesia after laparotomy. The drug is injected into the extradural space where it acts on the nerve roots. This technique is less likely to cause hypotension than spinal anaesthesia. Continuous analgesia is achieved if a local anaesthetic, often mixed with an opioid, is infused through an epidural catheter. 

It is an all-purpose local anaesthetic drug used frequently in surface infiltration, block, caudal and spinal anaesthesia. It is reported to be 10 times more toxic and potent than procaine, whereas its duration of action is twice than that of procaine. 

Severe hypotension and bradycardia have been seen in patients taking captopril or verapamii when they were given epidurai anaesthesia with bupivacaine. Acute hypotension aiso occurred in a man taking prazosin when he was given epidurai anaesthesia with bupivacaine. Cionidine may increase the duration of caudal block with bupivacaine, aithough there are reports of reduced plasma levels of lidocaine with concurrent cionidine. Verapamil does not appear to interact with epidural lidocaine. 

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