Peripheral Nerve Blocks: A Color Atlas, 3rd Edition

54.Pudendal Nerve Block

Giorgio Ivani

Valeria Mossetti

Patient Position: The patient lies supine.

Indications: Anesthesia of the posterior part of the scrotum.

Needle Size: A very short beveled needle.

Volume: 0.1 mL/kg of ropivacaine 0.2% for children up to 7 years, levobupivacaine 0.5% for older children, up to 5 mL per side.

Anatomic Landmarks: Ischial tuberosity.

Approach and Technique: The patient is supine with the knees flexed and the plantar part of his feet joined. Mark the skin projection of the ischial tuberosity on both sides. At this level a very short beveled needle is inserted in a medial direction until a loss of resistance corresponding to the piercing of the obturator fascia is felt.

Tips

1.   This block is particularly useful to complete anesthesia following ilioinguinal/iliohypogastric nerve block when the posterior part of the scrotum is involved in surgery.

Suggested Reading

Dalens B, ed. Regional anaesthesia in infants, children and adolescents. Baltimore: Williams & Wilkins, 1995.