Pudendal anesthesia

Pudendal anesthesia (pudendal nerve block, pudendal block or saddle block) is a form of local anesthesia. Pudendal anesthesia can be used to diagnose as well as treat illnesses. A nerve block is the use of local anesthetic (e.g lidocaine) to inhibit the sensation of pain caused by one or multiple nerves. A nerve block can help doctors confirm what nerve is causing the pain to support a diagnosis. A nerve block can also be used to prevent pain before a procedure, or relieve chronic pain. Pudendal nerve blocks can be used to provide pain relief to this region for about 30 days, but has been reported to last months in some patients. It can also be used during anorectal surgery, urologic surgery, diagnosing or treating chronic perineal pain (i.e. pudendal neuralgia), and other gynecologic procedures The procedure can be done without imaging guidance, but fluoroscopy or ultrasound can be used. It is normally used during the second stage of labor because it does not relieve the pain from contractions that occur during the first stage. It may also prevent the bearing down reflex during a contraction, therefore it should not be used too early in labor. It can also be used for pain relief from episiotomy or perineal lacerations

Pudendal neuralgia

Chronic pain that arises in the rectum, anus, urethra or genitalia is considered chronic perineal pain or pudendal neuralgia. Patients that suffer from chronic perineal pain are most commonly female, affecting 1 in 7 women. It lowers post operative pain and the need for opioids just as it does for MIGS.

Contraindications

• Allergy to the local anesthetic drug
• Bleeding