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2022, Volume 30, Issue 2

Original Article

The greater trochanter method: A novel approach to localising sacral hiatus for caudal epidural block

Sheetal Kotgirwar, Rekha Lalwani, Sunita Athawale

Pages: 79-85


Introduction: Localization of sacral hiatus is a prerequisite for caudal epidural block. The present study verified the ‘equilateral triangle’ method for localization of sacral hiatus on cadavers and alsointroduced a new ‘greater trochanter’ method for the same.

Materials and Methods: Localization of the sacral hiatus by the two methods) Equilateral triangle & ii) Greater trochanter was verified and compared on 25 adult cadavers by three observers independently.

Results: The variability of localization was greater in case of equilateral triangle method as compared to greater trochanter method. It was thus observed that greater trochanter method was more superior in localization of sacral hiatus and was also less variable in its deviation from the sacral hiatus. The measure of deviation from the hiatus, where it could not be located correctly, was also less in greater trochanter method as compared to equilateral triangle method.

Conclusions: The greater trochanter method may be used for localization of sacral hiatus independently or in conjugation with other methods. This method is easy to perform as no measurements are required and can be effectively used in adults and obese individuals as well.

Keywords: Epidural Anaesthesia, Greater trochanter, Sacral cornu, Surface landmarks

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