Caudal epidural injections

After thorough skin preparation and a local injection of 2 ml lidocaine (lignocaine) 2%, 40 mg triamcinolone hexacetonide mixed with 10 ml lidocaine 0.5% and 10 ml normal saline was injected into the epidural space through the sacral hiatus with a 20G spinal needle. Sixteen patients (47%) were ultimately referred to the chronic pain management services for nerve root blocks and three (9%) for a surgical opinion on the basis of the results of a magnetic resonance imaging scan of their lumbar spine.