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Pudendal Block
Aka: Pudendal Block
- See Also
- Active Labor Anesthesia
- Latent Labor Anesthesia
- Non-Pharmacologic Pain Control in Labor
- Epidural Anesthesia
- Intrathecal Morphine
- Paracervical Block
- Indication
- Late first stage and second stage Labor Analgesia
- Mechanism
- Blocks Pudendal Nerve at levels S2 to S4
- Procedure
- Hold Needle guide with first 2 fingers
- Middle finger resting on ischial spine
- Insert needle through guide into the pudendal canals
- Lateral to ischial spine
- Inferior to sacrospinous ligament
- Aspirate prior to injection to avoid Pudendal Artery
- Inject 10 ml 1% Lidocaine, Polocaine or Chloroprocaine 2% and repeat on the opposite side
- Advantages
- No maternal Hypotension
- Rare Fetal Distress
- Disadvantages: Incomplete analgesia
- Contraction pain still felt
- Episiotomy extensions may not be fully covered
- Complications (if injecting too deep)
- Systemic toxicity
- Rectal puncture
- Hematoma formation
- Sciatic block