Background and Objectives The sacral foraminal subarachnoid block is a method to access the subarachnoid space at the sacral level through the upper posterior sacral foramina.

Method and Results This expanded case report describes the use of this technique in 40 patients, ranging in age from 34 to 100 years. In 38 patients, the sacral foraminal block was performed satisfactorily with adequate analgesia and without complications. In two patients, the technique was abandoned because of technical difficulties, and the block was done at the lumbar level. All the patients were monitored for up to 3 days after surgery with no complications noted. No postspinal headaches were observed.

Conclusions A sacral foraminal subarachnoid block is performed at the distal end of the dural sac. This technique is proposed as an alternative for a difficult lumbar or lumbosacral subarachnoid block.