A RANDOMIZED CONTROLLED TRIAL COMPARING ULTRASOUND GUIDED VERSUS CONVENTIONAL INJECTION FOR CAUDAL BLOCK IN CHILDREN UNDERGOING INFRA UMBILICAL SURGERIES

·       Regional anaesthetic techniques are known to  reduce the post-operative morbidity, provide early mobilisation and reduce opioid requirements. Caudal epidural block is a widely used regional anaesthetic technique especially in paediatric surgery to provide intraoperative and post-operative analgesia in surgeries below umbilical level(T10-S5 dermatomes). Conventional single shot caudal block technique involves the risk of dural or vascular puncture, intra osseous injection, soft tissue bulging and systemic toxicity. Many anatomic variations have been reported for sacral hiatus and sacral cornua. Therefore, success rate of classic caudal epidural technique has been reported to be about 75%. Ultrasonography is helpful for visualisation of the sacral hiatus, sacrococcygeal ligament, duramater, epidural space and distribution of local anaesthetic agent within the epidural space therefore significantly increases the block success rate. Indian data on caudal epidural block has been scarce and world over, the number of studies on ultrasound guided caudal epidural block is minimal. Hence we wish to conduct a randomised control study comparing ultrasound guided caudal block versus conventional caudal block in children undergoing elective infraumbilical surgeries. The primary outcome would be the first puncture success rate comparing both the arms. Other outcomes such as  block performing time, success of the block and complications would also be assessed. The study would be conducted over a period of 6 months in the department of anaesthesia at a tertiary care centre hospital in southern India.