Anatomical basis of transgluteal pudendal nerve block

Prat‐Pradal, Dominique; Metge, Liliane; Gagnard-Landra, Corine; Marès, P.; Dauzat, M.; Godlewski, G

doi:10.1007/s00276-008-0445-z

Cited by 15 publications

(7 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,53,57,60,61 Technique Pudendal nerve blocks may be performed through two approaches: anterior/perineal 1,2,7,54 or posterior/ transgluteal. 2,49,56,59,[62][63][64][65] The perineal approach is used for distal entrapments or for anaesthetic/analgesic purposes in gynaecological, urological or colorectal surgery. The posterior approach has been used in recent years in proximal nerve entrapment syndrome, with a high rate of success in terms of the diagnostic/therapeutic objective, although with a moderate 21.7% risk of sacral plexus blockade.…”

Section: Pudendal Nerve Anatomymentioning

confidence: 99%

Regional anesthesia guided by ultrasound in the pudendal nerve territory☆

Rojas-Gómez

Blanco-Dávila

Roa

et al. 2017

Colombian Journal of Anesthesiology

View full text Add to dashboard Cite

Introduction: Pudendal nerve blocks have a wide range of clinical applications for the management of acute post-operative pain in urologic, gynecological surgery, in coloproctology, as well as in pain medicine for differential diagnosis, and for the management of pudendal neuropathies. However, despite its benefits it is infrequently used.Objective: To perform a detailed description of the most recent ultrasound-guided techniques with the aim of encouraging safe and reproducible learning. Materials and methods:We have performed a broad, non-systematic review of the literature through Medline, Embase and Science Direct between 1985 and 2016, to evaluate the most relevant articles, using the following key words: pudendal nerve anatomy, pudendal nerve, pudendal nerve blocks, pudendal nerve ultrasound, pudendal neuralgia, nerve entrapment, chronic pain, Alcock canal, and pelvic pain. The search was limited to articles published in Spanish, English and French.Results: Recent descriptions were found of a large number of anatomic variants, which are described in detail and shown in graphic documents in order to facilitate the sonoanatomic correlation of nerve location as a guide for the performance of the pudendal nerve block through the different approaches.

show abstract

Section: Pudendal Nerve Anatomymentioning

confidence: 99%

Regional anesthesia guided by ultrasound in the pudendal nerve territory☆

Rojas-Gómez

Blanco-Dávila

Roa

et al. 2017

Colombian Journal of Anesthesiology

View full text Add to dashboard Cite

show abstract

“…23,24 However, cost-intensive radiologic surveillance is necessary, and it only has an efficacy of 50% local anesthesia. 21,25,26 We tested the effectiveness of Therapeutic Local Anesthesia (TLA, in Central Europe also known as Neural Therapy) 27 on vulvodynia. TLA is an effective method to treat chronic pain.…”

Section: Introductionmentioning

confidence: 99%

“…Topical self-application of lidocaine decreased dyspareunia. 20 Injections of procaine 1%, a short-acting local anesthetic (LA) to the pudendal nerve via trans-gluteal 21 or dorsal access were performed. 22 Combined injections of LAs to the pudendal nerve, affected vulvar area, and impar ganglion improved both forms of vulvodynia, LPV and GVD.…”

Section: Introductionmentioning

confidence: 99%

“… 23 , 24 However, cost-intensive radiologic surveillance is necessary, and it only has an efficacy of 50% local anesthesia. 21 , 25 , 26 …”

Section: Introductionmentioning

confidence: 99%

“… 30 Application routes were: Local infiltrations, 24 , 31 intracutaneous injections, or regional blockades such as transperineal pudendal nerve blockade. 32 This technique consists of repeatedly injecting LA into the respective nerve, is highly effective (90% anesthesia of the perineum), and makes therapy more comfortable for patients than trans-gluteal 21 or intravaginal techniques. 23 A local approach was chosen by Rey-Novea et al 31 who injected LAs in tender vulvar areas with good success rates for six months or more.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Therapy With Local Anesthetics to Treat Vulvodynia. A Pilot Study

et al. 2022

View full text Add to dashboard Cite

Introduction: Vulvodynia (chronic vulvar pain) is a sexually debilitating disorder with a prevalence of »x223C10%.Aim: To investigate the effectiveness of therapy with local anesthetics (TLA) in women with severe vulvodynia, we conducted a prospective, non-controlled observational study. Methods: 45 patients with severe chronic vulvodynia (primary and secondary vulvodynia, 0−10 numeric analogue scale (NAS) ≥6, median 7.9, duration ≥6 months, median 65.2 months) in an outpatient practice in Germany were treated with TLA in 3−12 sessions using procaine 1% as local anesthetic. Effectiveness was analyzed with Wilcoxon signed rank tests and Wilcoxon rank sum tests. Outcomes: Therapeutic success as a reduction of pain to ≤4 NAS lasting for ≥6 months after end of therapy.Results: TLA successfully reduced vulvodynia in 36 of 45 patients (80 %, responders). The NAS reduction was from 7.9 to 2.4 (P < .001). Even patients denominated as non-responders experienced a significant reduction in NAS (P = .03). In responders, long-term success was observed for 6.8−125 months (median 24.1 months). No adverse events occurred. Clinical Translation: A promising new treatment for a hard-to-treat chronic female pain disorder. Strengths and Limitations: Limitation: Monocentric, non-controlled observational design; Strength: the high number of patients treated. Conclusion:The high success rate of TLA in this investigation offers new perspectives on the etiology of vulvodynia as a complex pain syndrome affecting several nerves of the pelvic floor, and also provides early insight into the effectiveness of TLA in women with vulvodynia.

show abstract