Sacral hiatus anatomical variations and clinical relevance in caudal epidural block

Abstract

Objective: For the management of perioperative pain control during procedures like genitourinary surgery and labor pain instances when the sacral epidural space technique is utilized for the application of analgesia, caudal epidural anesthesia (CEB) is frequently used. CEB is an anesthetic that is injected through the sacral hiatus (SH) into the sacral canal. Anatomical features of sacral hiatus that are in-depth are needed for the best possible access to the sacral epidural area. By employing the sacral bone as a point of reference to failure parameters for evaluating caudal epidural anesthesia and refining the success factors in practice, this study intends to explore the anatomical structures and variations of the Sacral hiatus. Material and methods: 85 sacral bones had their alignment points measured precisely morphometrically. Virtual calipers were used to take the readings were used to evaluate those utilizing photogrammetric techniques. Results: Inverted U was the most frequent sacral hiatus form reported (33.32%), although bifida and 6.8% 3.44% of cases frequently missing sacral hiatus were also seen. The mean Sacral hiatus length was 28.67.0 mm, the mean intracorneal distance was 13.472.68 mm, and the mean gap between the apex of the Sacral hiatus and S2 sacral foramen was 34.677.08 mm.