Caudal Block for pain relief after surgery

What is a caudal block?

It is a pain relieving injection at the base of the back, which is done while your child is asleep under general anaesthetic. The pain relieving effect can last for 4 – 12 hours and sometimes longer. It numbs the lower half of the body (from the belly button downwards) and is often used for surgery on the lower tummy, groin or legs. 

How is a caudal block performed?

When your child is asleep, they will be turned on their side and their lower back will be carefully cleaned. Under sterile conditions, the anaesthetist will insert a small cannula (plastic tube) into the base of the back and inject medicine to numb nerves and block pain sensations. The cannula is then removed.

Why is a caudal block performed?

A caudal block can provide very good pain relief, during and after your child’s operation making it easier for them to recover faster. By numbing the nerves, your child will feel little or no pain. This reduces the need for strong painkillers with unwanted side-effects such as vomiting and sleepiness. 

Are there any side-effects?

Numbness or weakness

• For the 4 – 12 hour period that the caudal block is working, your child may have numb, weak or tingling legs.

Passing urine 

• Occasionally, there may be some difficulty in passing urine. This side-effect will disappear as the block wears off.

Failure

• In a small number of children, it may not be possible to perform a caudal block or it may not work completely. In this case, your child will be given other painkillers to keep them comfortable.

Bleeding / Infection / Nerve damage

• The risk of bleeding or nerve damage is very low. Infection is unlikely as the block is done under sterile conditions in an operating theatre.

Is it safe?

Caudal blocks have been performed in children for more than 30 years and have a very good safety record. Several large studies have confirmed that caudal blocks are very safe. 

What to expect after the operation

• For the first 1 – 2 hours, your child’s leg muscles might not be as strong as they think they are. They may need additional support when first moving or standing.
• Your child’s legs may be numb and may ‘tingle’ for a few hours after surgery. You should supervise them closely and keep them away from anything hot or sharp as they will not feel pain in the same way as normal.
• Your child may have a small bruise where the injection was carried out.

What happens when the caudal block wears off?

Your child will need some other pain relief before this happens. You will be given advice about this before going home but it will include taking regular medication such as Paracetamol and Ibuprofen.

Contact details:

If you have any concerns about your child when you get home, you should contact the ward from which your child was discharged for further advice during normal working hours, 8:00 am – 8:00 pm.