Information following a caudal block
What is caudal anaesthesia?
When your child has an operation, the general anaesthetic will make your child unconscious. Pain relief before and during the operation can be provided using pain relieving medicines that will affect the whole body or alternatively by injecting local anaesthetic to numb (block) the area of the operation.
What is a caudal block?
- This is an injection of local anaesthetic (numbing agent) into the caudal space, at the base of your child’s spine
- It is a good form of pain relief for children who are having operations below the level of their belly button
- It provides pain relief both during and after the operation
- It may last for up to six hours or more
- Your anaesthetist will discuss this with you before your child goes to have their operation
Benefits
- Numbing the nerves at the base of the back , means your child will feel little or no pain
- Avoids needing to use strong pain relief which have side effects
- Reduce sickness and usually decreases recover time after the operation
Complications
Your anaesthetist will discuss these with you before the operation.
Common
Weak / heavy legs
- This is the most common side effect and occurs as the block affects the nerves supplying the legs. It is temporary and strength to the legs will return to normal as the block wears off
Inadequate pain relief
- In about 1 in 20 children the block does not work
- If this is the case the anaesthetist will give your child other forms of pain relief
Difficulty passing urine
- Usually, this is not a problem and patients manage to pass urine when they have had enough fluid to drink
- Rarely, a catheter needs to be inserted temporarily into your child’s bladder to empty it
Uncommon
Sedation
This may occur if your child has been given other pain relief along with the local anaesthetic (caudal block).
Itching
This may occur if your child has been given morphine like pain relieving medication in addition to local anaesthetic.
Rare
Nerve damage
This occurs in less than 1 in 10,000 and may be temporary or permanent.
Very rare
The following are very rare recognised complications and checks are taken throughout the process to prevent these
Your child’s anaesthetist will discuss them in more detail
- Infection
- Haematoma (bruise)
- Injection of local anaesthetic in blood / spinal space
Advice at home
It is safe for children to be discharged the same day as having had a caudal block.
Pain relief
It is important to give your child regular mild pain relief (Paracetamol/ Ibuprofen) as advised by your clinician, even if your child is comfortable. This will help as the caudal block starts to wear off and can be gradually reduced in frequency over the next couple of days.
Safety
- Key safety information is listed overleaf
Key points
Continue regular mild pain relief at home and decrease slowly.
It may take 12 hours for the normal feeling to return to your child’s legs.
- Avoid hot baths / hot water bottles
- supervise your child while crawling
Keep child well hydrated
- Encourage your child to drink water
Monitor for difficulty passing urine
- Inability to pass any urine
- Pain in the lower tummy
- Bloated lower tummy
If your child has not passed urine in 8-10 hours after the operation or has these problems please contact your GP or go to your local Emergency Department.