What is the appropriate needle angle for inserting a needle in a caudal epidural block?

• A. 90 degrees to the spine
• B. 45 degrees to the spine
• C. 30 degrees to the spine
• D. 180 degrees to the spine

Answer: (B)

The appropriate needle angle for inserting a needle in a caudal epidural block is 45 degrees to the spine. This angle allows for optimal access to the epidural space, ensuring that the needle enters at an angle that is conducive for introducing anesthetic agents while minimizing the risk of damaging surrounding structures.

In a 45-degree angle approach, the needle can be advanced in a controlled manner towards the sacral hiatus, which is located at the caudal end of the vertebral column. This adjustment helps ensure that the needle passes through the skin and subcutaneous tissues effectively, reaching the target area with the least amount of resistance.

Using a 90-degree angle might be too steep for this particular type of block, increasing the risk of injury to the tissues and possibly missing the epidural space. A 30-degree angle, while still relevant for some procedures, may not provide sufficient access to effectively reach the caudal epidural space. Lastly, a 180-degree angle is not a typical approach for this technique and would not align the needle properly with the anatomical target.