Pudendal Anesthesia

CHAPTER 174 Pudendal Anesthesia



Pudendal nerve anesthesia is a common nerve block technique used in obstetrics and minor gynecologic surgery. Its advantages include its safety, ease of administration, and rapidity of onset. Pudendal nerve block can be used to provide analgesia during the second stage of labor and to facilitate pelvic floor relaxation when using low forceps and vacuum extraction. It also provides anesthesia for the perineum in order to create or repair an episiotomy. Pudendal nerve anesthesia can be used for minor surgery of the lower vagina and perineum. Epidural anesthesia has largely supplanted the use of pudendal nerve anesthesia, but pudendal blocks are an alternative when neuraxial blockade is not feasible, not effective, or contraindicated. Although both transperineal and transvaginal approaches for pudendal blockade are options, the transvaginal approach is more practical and used most often. Therefore, only the transvaginal approach is discussed here.








Preprocedure Patient Preparation


Explain the potential risks (see the Contraindications and Complications sections) and the potential benefits to the patient so she may make an informed decision. This discussion should include alternatives and occur before the moment of greatest anesthetic need, when neither the patient nor the clinician can communicate optimally. Ideally, anesthesia should be decided as part of a birth plan, and this should be discussed and written well before the pregnancy is at term.

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May 14, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Pudendal Anesthesia

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