A pudendal block is a medical procedure used in pregnancy and childbirth whereby an anesthetic is injected into the pudendal nerve, which is responsible for sensation in the perineum (the area between the vagina and anus).
The pudendal nerve is a mixed nerve that arises from the sacral plexus. It is composed of both motor and sensory fibers. The motor fibers innervate the muscles of the perineum, while the sensory fibers innervate the skin and mucous membranes of the perineum. The pudendal block is used to numb the area during childbirth so that the mother does not feel pain during the delivery.
How it is Performed
A pudendal block is typically performed using a local anesthetic, such as lidocaine or bupivacaine. The anesthetic is injected into the pudendal nerve at its origin in the sacral plexus. The needle is inserted into the buttocks through a small incision and directed toward the sacral promontory. Once the needle is in place, a local anesthetic is injected around the nerve.
Pudendal block can also be performed using a neuraxial approach, such as a spinal or epidural block. In this case, a local anesthetic is injected into the epidural space surrounding the spinal cord. This technique may be particularly useful for women who are pregnant and have already had neuraxial anesthesia for labor and delivery.
Complications Associated with the Procedure
A pudendal block is generally safe and well-tolerated. Complications are rare. However, there are some potential complications associated with the procedure. These include:
- Nerve damage
- Allergic reactions
Other Related Terms
Other terms closely related to pudendal block include:
- Pudendal nerve block
- Perineal block
- Epidural block
This image shows how often the term ‘Pudendal Block’ is used in relation to other, similar birth terms:
There are other types of nerve blocks used during labor and delivery, such as epidural, spinal anesthesia, and general anesthesia. Epidural anesthesia numbs the nerves of the lower spine, providing comprehensive pain relief for the mother. Spinal anesthesia numbs the nerves of the entire spinal cord, providing complete pain relief but also causing loss of feeling and muscle function below the level of the block. General anesthesia numbs the entire body and is used for surgical procedures.
Each option has its own benefits and risks, so it’s important to discuss all of your options with your doctor or midwife before making a decision about which type of anesthesia to use.
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