Pudendal anesthesia

Pudendal anesthesia (pudendal nerve block, pudendal block or saddle block) is a form of local anesthesia commonly used in the practice of obstetrics to relieve pain during the delivery of baby by forceps. The pudendal nerve block prevents fainting during forceps delivery which was common before pudendal nerve block use was available. The anesthesia is produced by blocking the pudendal nerves near the ischial spine of the pelvis.[1][2] The ischial spine separates the greater and lesser sciatic foramina at the exit of the bony pelvis.

Pudendal anesthesia
Approximate area of "saddle anesthesia" seen from behind (yellow highlight)
Other names	Saddle block
Specialty	anaesthesiology

The pudendal block gets its name because a local anesthetic, such as lidocaine or chloroprocaine, is injected into the pudendal canal where the pudendal nerve is located. This allows quick pain relief to the perineum, vulva, and vagina. A pudendal block is usually given in the second stage of labor just before delivery of the baby. It relieves pain around the vagina and rectum as the baby comes down the birth canal. It is also helpful just before an episiotomy. Lidocaine is usually preferred for a pudendal block because it has a longer duration than chloroprocaine which usually lasts less than one hour.[3]

References

Maclean, Allan; Reid, Wendy (2011). "40". In Shaw, Robert (ed.). Gynaecology. Edinburgh New York: Churchill Livingstone/Elsevier. pp. 599–612. ISBN 978-0-7020-3120-5; Access provided by the University of Pittsburgh{{cite book}}: CS1 maint: postscript (link)
"Clinical Case - Perineum & External Genitalia". Archived from the original on 2009-02-27. Retrieved 2009-05-27.
"Pudendal Block". April 26, 2012.

Anesthesia and anesthesiology
Types	General Sedation Procedural sedation and analgesia Twilight anesthesia Local Continuous wound infiltration Topical Neuraxial blockade Combined spinal and epidural anaesthesia Epidural anesthesia Spinal anaesthesia Nerve block Brachial plexus block Fascia iliaca block Femoral nerve block Inferior alveolar nerve block Intercostal nerve block Interpleural block Intravenous regional anesthesia Occipital nerve block Paracervical block Pudendal nerve block Retrobulbar block Sciatic nerve block Transverse abdominis plane block Total intravenous anaesthesia
Pharmacologic agents	Anticholinergics Antiemetics Butyrophenones Benzodiazepines General anesthetics Inhalational anesthetics Local anesthetics Neuromuscular-blocking drugs Opioids Sedatives
Techniques	Airway management Anesthesia provision in the US Bronchoscopy Dogliotti's principle Intravenous therapy Laryngoscopy Tracheal intubation Rapid sequence induction
Scientific principles	Blood–gas partition coefficient Concentration effect Fink effect Minimum alveolar concentration Second gas effect
Measurements	ASA physical status classification system Baricity Bispectral index Body mass index Capnography Entropy monitoring Fick principle Goldman index Guedel's classification Intraoperative neurophysiological monitoring Mallampati score Neuromuscular monitoring Pain scale Thyromental distance
Instruments	Anaesthetic machine Anesthetic vaporizer Arterial catheter Bronchial blocker Double-lumen endobronchial tube Gas cylinder Laryngeal mask airway Laryngeal tube Magill forceps Relative analgesia machine Tracheal tube
Complications	Allergic reactions Anesthesia awareness Drug-induced amnesia Effects of early-life exposures to anesthesia on the brain Emergence delirium Local anesthetic toxicity Malignant hyperthermia Perioperative mortality Postanesthetic shivering Postoperative nausea and vomiting Postoperative residual curarization
Subspecialties	Cardiothoracic Critical emergency medicine Geriatric Intensive care medicine Obstetric Oral sedation dentistry Pain medicine
Professions	Anesthesiologist Anesthesiologist assistant Nurse anesthetist Operating department practitioners Certified anesthesia technician Certified anesthesia technologist Anaesthetic technician Physicians' assistant (anaesthesia)
History	ACE mixture Helsinki Declaration for Patient Safety in Anaesthesiology History of general anesthesia History of neuraxial anesthesia History of tracheal intubation
Organizations	American Association of Nurse Anesthetists American Society of Anesthesia Technologists & Technicians American Society of Anesthesiologists Anaesthesia Trauma and Critical Care Association of Anaesthetists of Great Britain and Ireland Royal College of Anaesthetists Association of Veterinary Anaesthetists Australian and New Zealand College of Anaesthetists Australian Society of Anaesthetists International Anesthesia Research Society
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