- Late first stage and second stage Labor Analgesia
- Blocks Pudendal Nerve at levels S2 to S4
- 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
- Disadvantages
-
Incomplete analgesia
- Patient loses reflex to bear down
- Reserved for use immediately prior to impending delivery
- Contraction pain still felt
- Episiotomy extensions may not be fully covered
- Rare use in practice
- Ford (2013) J Obstet Gynaecol 33(5):463-5 [PubMed]
- Complications (if injecting too deep)
- Systemic toxicity
- Rectal puncture
-
Hematoma formation
- Sciatic block
- Infection
- Nerve Injury
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