Pudendal Block: An Obstetric Procedure That Needs Critical Evaluation

The efficacy of pudendal block anaesthesia was evaluated in three centres by obstetric staff of different seniority. In one centre a Med-E-Jet which drives and disperses the drug at high velocity was used. The results obtained by objective testing of pain gave a complete bilateral block in 50% of cases. In 16.7% of the cases the block was adequate only on the left side with partial or no analgesia on the opposite side; the corresponding figure for the right side was 8.9%. The remaining 24.4% of cases needed additional local infiltration and was considered as failures. The seniority of the obstetric staff or the equipment used did not improve the results. The highest success rate was achieved by staff using the method routinely. Caution is expressed in performing trial of forceps or rotational forceps delivery under pudendal block anaesthesia without objectively testing for the results achieved by the block. Considering the success obtained in unilateral blockade there is room for improving the block achieved on both sides.