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.
Abstract: The effectiveness of an emollient as an adjunct to topical corticosteroid therapy for the treatment of mild to moderate atopic dermatitis was studied for 3 weeks in 25 children 3 to 15 years of age in comparison with corticosteroid therapy alone. The adjunctive regimen of a once-daily application each of hydrocortisone % cream and of a water-in-oil cream was equivalent in efficacy to the comparative regimen of twice-daily applications of hydrocortisone % cream. Both treatment regimens elicited significant improvement in skin condition by day 7 (p < ) and further significant improvement by day 14 (p < ). No significant differences between the two treatment regimens were observed in the rates of improvement (p > ) or in the reductions in mean lesion size (p > ). No differences were observed in parental evaluations, except for ease of application where a slight preference was expressed for the hydrocortisone % cream preparation (p < ). We conclude that emollient adjunct i ve therapy offers a steroid-sparing alternative to topical corticosteroids alone in the treatment of mild to moderate atopic dermatitis.