Central Neuraxial Anatomy and Anesthetic Application (Central Neuraxial Blockade)

Epidural, spinal, and caudal anesthesiaCaudal anesthesia comprises the most commonly used regional anesthetic techniques referred to as neuraxial anesthesiaNeuraxial anesthesia. These techniques may not only provide a means for the primary anesthetic during surgery but are commonly used for perioperativePerioperative and postoperative analgesia in addition to its widespread use in controlling labor pain. While the clinician may have performed these techniques for years, it is helpful to review the important concepts in order to safely and effectively deliver the best care for the patient undergoing neuraxial anesthesiaNeuraxial anesthesia. This chapter reviews relevant anatomyAnatomy, pharmacologyPharmacology, and standard techniques as well as newer approaches using ultrasound guidanceUltrasound guidance for neuraxial blockadeNeuraxial blockade. Finally, this chapter covers indications for providing neuraxial techniques and complications that may arise, and presents the latest guidelines for treating the anticoagulated patient when considering neuraxial anesthesiaAnesthesia.