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Korean J Anesthesiol > Volume 50(3); 2006 > Article
Korean Journal of Anesthesiology 2006;50(3):332-336.
DOI: https://doi.org/10.4097/kjae.2006.50.3.332   
Anatomical Variations Which Can Result in Inadvertent Dural Puncture When Performing Caudal Block: A report of 3 cases.
Byung Cheol Park, Bum Soo Kim, Won Jung Hwang, Jaemin Lee, Dong Eon Moon
1Department of Anesthesiology and Pain Medicine, School of Medicine, The Catholic University of Korea, Korea. jmlee@catholic.ac.kr
2Dr. Park's Pain Clinic, Korea.
3Department of Radiology, School of Medicine, The Catholic University of Korea, Seoul, Korea.
There are reports showing considerable morphological abnormalities in the lumbosacral region, which are usually caused by certain diseases or simply by anatomical variations. It is possible that if a caudal block is performed in patients with these anatomical abnormalities it will either fail or another unexpected difficult situation will result. However, there is no case report regarding such issues. We experienced two cases of an unexpected dural puncture during a trial of caudal block, and one case in whom the dural puncture would most likely have been caused by a trial of caudal block. The dural punture was caused by morphological abnormalities in the lumbosacral region i.e., diffuse ectasia of the lumbosacral dura and a posterior sacral meningocele with an enlargement of the lumbosacral canal. The dural termination was located more distally in the potential dural puncture case than in the normal cases.
Key Words: anatomical variations; caudal block; dural puncture; lumbosacral
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