Pudendal: Difference between revisions

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Pudendal Nerve Block

1. Introduction

Overview of the pudendal nerve and relevance in pediatric anesthesia
Typical indications (e.g., circumcision, hypospadias, anorectal surgery, urologic procedures)
Advantages compared to caudal or dorsal penile/clitoral blocks

2. Anatomy and Related Structures

3. Techniques and Approaches

3.1 Ultrasound-Guided Techniques

3.2 Nerve Stimulator and Landmark Approaches

4. Pediatric and Clinical Applications

4.1 Pediatric Urologic Surgery

How I Do It: The pudendal nerve block for pediatric ambulatory urologic surgery

4.2 Hypospadias and Circumcision

5. Other Clinical Studies and Adult Data (Contextual)

A randomized controlled trial of pudendal nerve block for pain relief after episiotomy

6. Summary of Evidence

Comparative outcomes in pediatric vs adult data
Analgesic duration, success rates, and complications
Role of ultrasound guidance in improving safety and efficacy

7. References and Further Reading

Full citation list with PubMed/DOI links for easy reference

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-[https://player.vimeo.com/video/464216443 OA-SPA Pediatric Anesthesia Virtual Grand Rounds: Ultrasound-guided Pudendal Nerve Block for Children in the Lithotomy Position]
+== Pudendal Nerve Block ==
-[https://www.canjurol.com/html/free-articles/Cdn_JU28_I2_19_FREE_DrOkoro.pdf How I Do It: The pudendal nerve block for pediatric ambulatory urologic surgery]
+=== 1. Introduction ===
+* Overview of the pudendal nerve and relevance in pediatric anesthesia
+* Typical indications (e.g., circumcision, hypospadias, anorectal surgery, urologic procedures)
+* Advantages compared to caudal or dorsal penile/clitoral blocks
-[https://pubmed.ncbi.nlm.nih.gov/29205687/ Ultrasound-guided pudendal nerve block in children: A new technique of ultrasound-guided transperineal approach]
+=== 2. Anatomy and Related Structures ===
+* [https://pubmed.ncbi.nlm.nih.gov/14725700/ Anatomy of the pudendal nerve and its terminal branches: a cadaver study]
+* [https://pubmed.ncbi.nlm.nih.gov/15768420/ Anatomical study of the pudendal nerve adjacent to the sacrospinous ligament]
+* [https://pubmed.ncbi.nlm.nih.gov/8638766/ Variations in the branching of the internal pudendal artery in the ischioanal fossa]
-[https://pubmed.ncbi.nlm.nih.gov/24257391/ The effectiveness of pudendal nerve block versus caudal block anesthesia for hypospadias in children]
+=== 3. Techniques and Approaches ===
-[https://rapm.bmj.com/content/41/5/610  Pudendal Versus Caudal Block in Children Undergoing Hypospadias Surgery: A randomized Controlled Trial]
+==== 3.1 Ultrasound-Guided Techniques ====
+* [https://pubmed.ncbi.nlm.nih.gov/29205687/ Ultrasound-guided pudendal nerve block in children: A new technique of ultrasound-guided transperineal approach]
+* [https://pubmed.ncbi.nlm.nih.gov/11584221/ New, simple, ultrasound-guided infiltration of the pudendal nerve: ultrasonographic technique]
+* [https://pubmed.ncbi.nlm.nih.gov/18299095/ Feasibility of real-time ultrasound for pudendal nerve block in patients with chronic perineal pain]
+* [https://pubmed.ncbi.nlm.nih.gov/22430025/ Randomized controlled trial comparing pudendal nerve block under ultrasound and fluoroscopic guidance]
+* [https://pubmed.ncbi.nlm.nih.gov/26780419/ Ultrasound-Guided Pudendal Nerve Block at the Entrance of the Pudendal (Alcock) Canal: Description of Anatomy and Clinical Technique]
+* [https://player.vimeo.com/video/464216443 OA-SPA Pediatric Anesthesia Virtual Grand Rounds: Ultrasound-guided Pudendal Nerve Block for Children in the Lithotomy Position]
-[https://pubmed.ncbi.nlm.nih.gov/18633043/  A randomized controlled trial of pudendal nerve block for pain reliefafter episiotomy]
+==== 3.2 Nerve Stimulator and Landmark Approaches ====
+* [https://link.springer.com/article/10.1007/BF03021848 Nerve stimulator guided pudendal nerve block versus general anesthesia for hemorrhoidectomy]
+* [https://pubmed.ncbi.nlm.nih.gov/15625258/ Nerve stimulator guided pudendal nerve block decreases posthemorrhoidectomy pain]
-[https://link.springer.com/article/10.1007/BF03021848 Nerve stimulator guided pudendal nerve block versus general anesthesia for hemorrhoidectomy]
+=== 4. Pediatric and Clinical Applications ===
-Naja Z, Ziade MF, L€onnqvist PA. Nerve stimulator guided pudendalnerve block decreases posthemorrhoidectomy pain.Can  J  Anaesth.2005;52:62-68.
+==== 4.1 Pediatric Urologic Surgery ====
+* [https://www.canjurol.com/html/free-articles/Cdn_JU28_I2_19_FREE_DrOkoro.pdf How I Do It: The pudendal nerve block for pediatric ambulatory urologic surgery]
-Naja Z, Al-Tannir MA, Faysal W, Daoud N, Ziade F, El-Rajab M. Acomparison of pudendal block vs dorsal penile nerve block for cir-cumcision in children: a randomised controlled trial.Anaesthesia.2011;66:802-807.
+==== 4.2 Hypospadias and Circumcision ====
+* [https://pubmed.ncbi.nlm.nih.gov/24257391/ The effectiveness of pudendal nerve block versus caudal block anesthesia for hypospadias in children]
+* [https://rapm.bmj.com/content/41/5/610 Pudendal Versus Caudal Block in Children Undergoing Hypospadias Surgery: A Randomized Controlled Trial]
+* [https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.2011.06753.x A comparison of pudendal block vs dorsal penile nerve block for circumcision in children: a randomized controlled trial]
-Polaner DM, Taenzer AH, Walker BJ, et al. Pediatric Regional Anes-thesia Network (PRAN): a multi-institutional study of the use andincidence of complications of pediatric regional anesthesia.AnesthAnalg. 2012;115:1353-1364.
+=== 5. Other Clinical Studies and Adult Data (Contextual) ===
+* [https://pubmed.ncbi.nlm.nih.gov/18633043/ A randomized controlled trial of pudendal nerve block for pain relief after episiotomy]
-Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: abehavioral scale for scoring postoperative pain in young children.Pediatr Nurs. 1997;23:293-297.
+=== 6. Summary of Evidence ===
+* Comparative outcomes in pediatric vs adult data
+* Analgesic duration, success rates, and complications
+* Role of ultrasound guidance in improving safety and efficacy
-Fronh€ofer G, Niernberger T, Anderhuber F. Variations in the branch-ing of the internal pudendal artery in the ischioanal fossa.Ann  Anat.1996;178:133-135.
+=== 7. References and Further Reading ===
+* [https://pubmed.ncbi.nlm.nih.gov/?term=Child+anesthesia+pudendal+block&sort=date  Full citation list with PubMed/DOI links for easy reference]
-Mahakkanukrauh P, Surin P, Vaidhayakarn P. Anatomical study ofthe pudendal nerve adjacent to the sacrospinous ligament.Clin  Anat.2005;18:200-205.
-Schraffordt SE, Tjandra JJ, Eizenberg N, Dwyer PL. Anatomy of thepudendal nerve and its terminal branches: a cadaver study.ANZ  JSurg. 2004;74:23-26.
-Kovacs P, Gruber H, Piegger J, Bodner G. New, simple, ultrasound-guided infiltration of the pudendal nerve: ultrasonographic tech-nique.Dis Colon Rectum. 2001;44:1381-1385.
-[https://pubmed.ncbi.nlm.nih.gov/18299095/  Feasibility of real-time ultrasoundfor pudendal nerve block in patients with chronic perineal pain]
-Bellingham GA, Bhatia A, Chan CW, Peng PW. Randomized con-trolled trial comparing pudendal nerve block under ultrasound andfluoroscopic guidance.Reg Anesth Pain Med. 2012;37:262-266.
-[https://pubmed.ncbi.nlm.nih.gov/26780419/  Ultrasound-Guided PudendalNerve Block at the Entrance of the Pudendal (Alcock) Canal:Description of Anatomy and Clinical Technique]
-[https://www.canjurol.com/html/free-articles/Cdn_JU28_I2_19_FREE_DrOkoro.pdf How I Do It: The Pudendal Nerve Block for Pediatric Ambulatory Urologic Surgery]