Anesthesia (16)

Abstract

Computed tomography—guided pudendal nerve block. A new diagnostic approach to long‐term anoperineal pain: a report of two cases. (Baylor College of Medicine, Houston, TX) Reg Anesth Pain Med 2000;25:420–423. This report showed the value of computed tomography (CT) in selectively blocking the pudendal nerve in patients with long‐term anogenital pain of uncertain etiology. In 1 patient, a competitive cyclist, blocking the nerve under CT substantiated the diagnosis of pudendal neuralgia. The procedure relieved the pain for approximately 24 h. In the other patient, pudendal nerve block produced perineal analgesia, but no pain relief. Superior hypogastric plexus block relieved the pain significantly for about 4 weeks on 2 separate occasions, suggesting sympathetically maintained pain. Conclude that the use of CT to guide the procedure allowed precision in performing the procedure and in making a differential diagnosis.