Transvaginal pudendal nerve block: A Simple Procedure for Effective Anesthesia in Operative Vaginal Delivery☆

Abstract In over 97 per cent of 156 patients who had transvaginal pudendal block, the anesthesia was considered good or excellent. Results were best when hyaluronidase was combined with 1 per cent procaine and epinephrine. At this point it is well to remember, however, the caution of Eckenhoff and Kirby 13 that “addition of hyaluronidase to a local anesthetic is not a substitute for the proficiency of the anesthetist or surgeon in performing regional nerve blocks”. The transvaginal procedure for obtaining a pudendal nerve block has the following advantages: 1. 1. Simplicity of performance. It can be carried out without aid. 2. 2. The site of injection is nearest to the nerve to be blocked, affording greater accuracy in direct nerve infiltration. 3. 3. The method is safe for mother and infant. No hematoma, infection, or other complication has been encountered in the past five years while this procedure has been used.