title: Caudal injectate can be reliably imaged using portable ultrasound--a preliminary study.
abstract: BACKGROUND
  Correct caudal cannula placement is essential for block success and the avoidance of complications. The aim of this study was to assess the use of a saline injection test bolus with ultrasound (US) imaging to identify correct cannula placement for caudal anesthesia.
  
  
  METHODS
  A prospective observational study of 60 children undergoing caudal anesthesia. A Sonosite 180 Plus (Sonosite Inc., Bothwell, WA) was used to image the spine and look for caudal space expansion secondary to saline injection.
  
  
  RESULTS
  Saline test bolus correctly identified position in 96.5% of all subjects, and was 100% successful in children under 2 years of age.
  
  
  CONCLUSIONS
  These preliminary results suggest saline test bolus under US imaging is a reliable indicator of correct cannula position for caudal block. We found it safe, quick to perform, and provided additional useful information.
authors.affiliation: Jackson Rees Department of Anaesthesia, The Royal Liverpool Children's NHS Trust, Alder Hey Hospital, Liverpool, UK. issus9@blueyonder.co.uk
authors.forename: Steven A
authors.initials: SA
authors.lastname: Roberts
authors.forename: Velu
authors.initials: V
authors.lastname: Guruswamy
authors.forename: Ignacio
authors.initials: I
authors.lastname: Galvez
mesh_terms: D000763:Anesthesia, Caudal / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods