The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.
The following patients should not have this injection: if you are allergic to any of the medications to be injected, if you are on a blood-thinning medication (. Coumadin, injectable Heparin), or if you have an active infection going on. With blood thinners like Coumadin, your doctor may advise you to stop this for 4-7 days beforehand or take “bridge therapy” with Lovenox prior to the procedures. Anti-platelet drugs like Plavix may have to be stopped for 5-10 days prior to the procedure. Aspirin should be stopped for cervical procedures for 10 days prior, but not for Lumbar.
If an epidural is recommended then the patient will likely undergo an MRI (magnetic resonance imaging) scan prior to treatment so as to ascertain the exact location of the troubled nerves. Epidurals are mostly conducted at outpatient clinics, or at the patient’s local surgery. Only qualified health professionals can administer the injections, such as anesthesiologists, radiologists, neurologists, and surgeons. Medical centers often have specific pain management clinicians who conduct epidurals and can advise on other methods to relieve neck pain from trauma such as whiplash , spinal stenosis, and arthritis.