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.
Fluticasone; vilanterol inhalation is not indicated for use in children. The safety and efficacy of the combination have not been established in infants, neonates, children, and adolescents. Available data from controlled clinical trials suggest that long-acting beta-agonists increase the risk of asthma-related hospitalization in pediatric and adolescent patients. Among subjects aged 12 to 17 years, asthma-related hospitalizations occurred in 4 subjects (%) treated with Breo Ellipta 100/25 (n = 151) compared with 0 subjects treated with fluticasone furoate 100 mcg (n = 130). There were no asthma-related deaths or asthma-related intubations observed in this trial. Growth inhibition has been observed in some children following therapy with high-dose fluticasone propionate inhalations (., Flovent). Children receiving fluticasone inhalations should be monitored closely for growth inhibition; the effect of fluticasone on final adult height is not known.