{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T10:08:12Z","timestamp":1780999692279,"version":"3.54.1"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T00:00:00Z","timestamp":1596067200000},"content-version":"vor","delay-in-days":59,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Caudal epidural anesthesia is a frequently performed regional anesthesia block in infants and young children. Traditional landmark\u2010based blind needle insertion remains the norm with no immediate, objective method to determine the presence of local anesthetic in the epidural space. Increasingly, ultrasound\u2010imaging is used in pediatric regional anesthesia with demonstrated improvements in block efficacy and efficiency. The value of ultrasound\u2010imaging in confirming success rate of traditional caudal placement is not well defined. <\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the success rate of conventional landmark\u2010based caudal technique using ultrasound\u2010imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective observational study of 30 children ages 1\u00a0month to 7\u00a0years undergoing surgical procedures with consent for caudal blockade. Provider success rate of caudal blockade placed by landmark technique was measured using ultrasound\u2010imaging of needle tip and local anesthetic flow in the epidural space.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ultrasound\u2010imaging demonstrated 80% success to correct positioning of the needle tip and local anesthetic in the epidural space. Failure was associated with decreasing experience and presence of anatomic variances. All improperly positioned needles were subsequently successfully positioned using real\u2010time ultrasound\u2010imaging. Mean time for confirmatory ultrasound\u2010imaging (SD; range) was 1\u00a0minute (0.3; 1\u20103).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of ultrasound\u2010imaging can be used to identify proper needle placement in the sacral epidural canal and facilitate subsequent corrected placement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.13865","type":"journal-article","created":{"date-parts":[[2020,4,8]],"date-time":"2020-04-08T11:49:15Z","timestamp":1586346555000},"page":"671-675","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Confirmation of success rate of landmark\u2010based caudal blockade in children using ultrasound: A prospective analysis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2799-9902","authenticated-orcid":false,"given":"Karen R.","family":"Boretsky","sequence":"first","affiliation":[{"name":"Department of 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