ABSTRACT : Distorted anatomy of sacral hiatus often makes Caudal epidural challenging and sometimes unsuccessful. We hypothesized that sacral epidural anaesthesia through dorsal foramen of sacrum with the help of nerve stimulator needle,will improve the success rate. In this case-series we had tried to evaluate the merits and demerits of sacral epidural anesthesia through third dorsal foramen of sacrum with the help of nerve stimulator needle.

METHODS : : 30 patients (50 -90 yrs) ASA I/II/III posted for surgical repair of old fracture of tibia were selected. Nerve stimulator needle was inserted through ipsilateral 3rd dorsal foramen of sacrum, nerve stimulation started just after skin puncture till the identification of epidural space by favourable neurological response i.e.movement of the great toe of ipsilateral side ,20 ml of 0.75% injection ropivacaine was injected in epidural space after confirming negative aspiration . Heart rate, blood pressure, onset and duration of sensory and motor block and upper level of sensory block were recorded. Data analysis was done by SPSS software

RESULTS : There was no bradycardia and hypotension. The mean±SD of onset time of motor and sensory (T12 level) block was (24±4.433) and (18.50±3.972) minutes respectively. The duration of sensory and motor block was (177±9.154) and (116.33±8.087) minutes respectively.

CONCLUSIONS : With improved hemodynamic stability, sacral epidural with the help of nerve stimulator needle through dorsal foramen is easy and definite technique to give epidural anaesthesia for lower limb surgeries in adult & elderly patients, even with spinal deformities.