It is imperative that the clinician has a good anatomical knowledge of the area being DN to be able to identify blood vessels, nerves and organs in the area. Where possible an arterial pulse should be palpated to avoid injuring the blood vessels. Map out the blood vessels and nerves where possible. Use pincer palpation, if possible, to bring the muscle away from the blood vessel or nerve. Slowly insert the needle and withdraw it immediately if the patient reports a stinging and/or burning pain possibly indicating penetration of a blood vessel or a shooting, stinging and/or burning pain in the case of a nerve [21]. Special care must be taken around the spine and suboccipital area to avoid penetrating the brain stem or the spinal meninges. Needle length must always be considered to avoid deep penetration and potential puncturing into the peritoneal cavity [14]