Pain at the puncture site — the most common complaint in the postoperative period. The most serious cause is periosteal injury (up to the subperiosteal hematoma) of the anterior wall of the sacral canal. Puncture of the sacrococcygeal ligament causes less pain, but after numerous and traumatic attempts to puncture it, the filtration with a local anesthetic will not interfere with the extraction of the needle.
Urinary retention after caudal anesthesia is not much more frequent than after any epidural. In older men and after surgery in the bladder area, naturally, this is more common. A single bladder catheterization is usually enough.
Infection is a serious threat because the skin in this area is easily contaminated. Therefore, it is necessary to take seriously the rules of asepsis and antisepsis, it is also advisable not to leave the catheter or cannula longer than a day. It is necessary to fix the catheter securely so that it does not move. Underneath it (immediately near the exit), you can tightly glue a strip of adhesive tape to the skin of the interyagodic fold, and then place another strip above the catheter.
An epidermoid cyst in the caudal canal may develop as a result of insertion of the epidermis on the needle (therefore, it is better to puncture the needle with mandrin or with a lateral opening, like the Whitacra spinal needle.
Neurological complications were very rare, mainly but after anesthesia of labor, and the causes were coccygodynia (pain in the coccyx), neuritis or neuralgia from the pressure of the fetal head.