Ultrasound-guided hydraulic-navigation caudal-epidural catheterization technique in children

Caudal-epidural block is an important component of multimodal anesthesia in neonates and young infants, yet current catheterization techniques provide no direct real-time control over the position of the echo-negative catheter tip; monitoring relies on tactile cues or delayed hemodynamic response. Aim. To compare a newly developed, patent-protected hydraulic navigation technique with the existing prototype and to assess its technical performance. Materials and methods. This prospective descriptive study included 36 children aged 0-3 years (neonates - 20, infants older than one month - 16) who underwent emergency abdominal surgery with caudal-epidural block as part of multimodal anesthesia. The prototype technique of Pisklakov et al. (2017) served as comparator; between-group comparison used Fisher's exact test. Results. First-attempt success was 65.0% (13/20) in neonates and 81.3% (13/16) in older infants (p=0.456). The overall technical complication rate was 13.9% (5/36), all resolved without sequelae; no severe complications occurred. Conclusion. The method differs from the prototype in its control principle - real-time, indirect monitoring during catheter advancement - improving the technical reliability of catheterization.