{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:29:11Z","timestamp":1786739351352,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Caudal epidural block is widely used in pediatric surgeries to provide intraoperative and postoperative analgesia in infra-umbilical surgeries. The conventional technique involves the risk of multiple punctures and other complications such as dural puncture, vascular puncture, and intraosseous injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>\n                      Around 106 children aged between 6 months to 10 years belonging to ASA class I-II scheduled for elective infra-umbilical surgeries were included after obtaining written informed consent from parents\/guardians. All children were randomized into two groups: ultrasound-guided (Group U) or conventional caudal group (Group C). All were premedicated with oral midazolam and inhalational induction was done with oxygen and 6\u20138% sevoflurane. Caudal block of 1 mL\/kg of 0.125% bupivacaine was administered in both groups. The primary outcome assessed was 1\n                      <jats:sup>st<\/jats:sup>\n                      puncture success rate and the secondary outcomes assessed were number of skin punctures, block performing time, and block success rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Group U had a higher first puncture success rate (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001) than Group C (90.6% v\/s 64.2%) and was statistically significant. The number of punctures were significantly less (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01) in Group U (1.09 \u00b1 0.295) than Group C (1.45 \u00b1 0.667). Block performing time was significantly higher (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0005) in Group U (53.19 \u00b1 10.97 s) than Group C (30.34 \u00b1 7.34 s). There was no difference in the overall block success rate between the groups (98.1% v\/s 100%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Ultrasound-guided caudal injection increases the first puncture success rate and decreases the number of punctures required compared to conventional caudal block in pediatric infra-umbilical surgeries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joacp.joacp_361_19","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T14:48:45Z","timestamp":1626360525000},"page":"249-254","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["A randomized double-blinded controlled trial comparing ultrasound-guided versus conventional injection for caudal block in children undergoing infra-umbilical surgeries"],"prefix":"10.4103","volume":"37","author":[{"given":"Navya","family":"Kollipara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. Rajesh Kumar","family":"Kodali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruna","family":"Parameswari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-17-20240828","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S0889-8537(05)70168-1","article-title":"Regional anesthesia in pediatrics","volume":"18","author":"Markakis","year":"2000","journal-title":"Anesthesiol Clin N Am"},{"key":"R2-17-20240828","doi-asserted-by":"crossref","first-page":"122","DOI":"10.3344\/kjp.2015.28.2.122","article-title":"A comparison of two techniques for ultrasound-guided caudal injection: The influence of the depth of the inserted needle on caudal block","volume":"28","author":"Doo","year":"2015","journal-title":"Korean J 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Anaesth"},{"key":"R12-17-20240828","doi-asserted-by":"crossref","first-page":"9217145","DOI":"10.1155\/2017\/9217145","article-title":"Caudal epidural block: An updated review of anatomy and techniques","volume":"2017","author":"Kao","year":"2017","journal-title":"BioMed Res Int"},{"key":"R13-17-20240828","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1155\/2014\/679128","article-title":"Assessment of factors affecting the difficulty of caudal epidural injections in adults using ultrasound","volume":"19","author":"Kim","year":"2014","journal-title":"Pain Res Manag"},{"key":"R15-17-20240828","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1111\/j.1365-2044.2006.04795.x","article-title":"Determination of the optimal angle for needle insertion during caudal block in children using ultrasound imaging","volume":"61","author":"Park","year":"2006","journal-title":"Anaesthesia"}],"container-title":["Journal of Anaesthesiology Clinical 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