Caudal Anesthesia for the Reduction of Femur Shaft Fracture in a Patient with Severe Kyphoscoliosis

We had experienced a successful caudal anesthesia for the intramedullary nailing of fractured femur shaft in a 39 years-old, male, adult weighing 47 kg with severe kyphoscoliosis. We had chosen caudal anesthesia as an anesthetic method because of his poor pulmonary function and severe deformity of thoracolumbar spine. Caudal anesthesia was performed with administration of the mixture of 6 mL of 2% lidocaine, 12 mL of 1.5% lidocaine, 10 mL of 0.5% bupivacaine, and 0.15 mg of 0.1% epinephrine. We could achieve the adequate anesthetic sensory dermatome level, L1, for the operation without any significant deterioration of blood pressures and respiration. We recommend that caudal anesthesia is a useful anesthetic method for a patient with severe kyphoscoliosis when the operation on hip or lower extremity is required.ope