1) Surgical, obstetrics and post-operative anaesthesia and analgesia.
2) Diagnostic
Deferential epidural block to evaluate pain from pelvic organs, and lower extremity.
3) Post traumatic pain from the pelvis and the lower extremity.
4) Lumber Radiculopathy secondary to lumber nerve root irritation.
5) Diabetic neuropathy.
6) Post herpetic neuralgia.
7) Reflex sympathetic dystrophy.
8) Cancer pain from pelvic organs and lower extremity.


Patient should lye either in prone or lateral position. One pillow should be placed below the pelvic of a patient is in prone position. Sacral hiatus should be palpated and then 21/22gage 1.5/3inch needle should be introduced. The needle position should be confirmed either by loss of resistance or by spread of radio opaque dye under C-arm.


Complication is very rare in expert hands. Potential complications are infection, haematoma, injury to the nerve roots, respiratory depression, sub-arachnoid/subdural injection of drugs etc.