The Anatomical Distribution of the Pudendal Nerve Block Injection: A Cadaveric Study
| Autor: | Tajnoos Yazdany, Yoko Takashima, Tam Hoang Le, Brian Miyazaki, Stephanie J Handler, Aldene Zeno, Charles Khamis, Isabel Del Canto, Pedro Alvarez |
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| Rok vydání: | 2020 |
| Předmět: |
Shortest distance
Urology Pudendal nerve 030232 urology & nephrology Ischial spine Posterior approach 03 medical and health sciences 0302 clinical medicine Ischium Cadaver Injection site medicine Humans 030219 obstetrics & reproductive medicine Blue dye business.industry Obstetrics and Gynecology Nerve Block Anatomy Pudendal Nerve medicine.anatomical_structure Vagina Female Surgery Cadaveric spasm business |
| Zdroj: | Female Pelvic Medicine & Reconstructive Surgery. 27:e306-e308 |
| ISSN: | 2151-8378 |
| Popis: | Objective The objective of this study was to assess the accuracy of commonly used injection locations of the pudendal nerve block by examining the proximity of the injected dye to the pudendal nerve in a cadaveric model. Methods Pudendal block injections at 4 sites were placed transvaginally on 5 cadaveric pelvises. These sites were 1 cm proximal to the ischial spine (black dye), at the ischial spine (red dye), 1 cm distal to the ischial spine (blue dye), and 2 cm lateral and 2 cm distal to the ischial spine (green dye). The cadavers were dissected via a posterior approach. Results We measured the shortest distance from the center of the dye-stained tissue to the pudendal nerve. As expected, the injections at the ischial spine (red) resulted in a distribution of dye closest to the pudendal nerve, averaging 3.0 ± 0.95 mm. Dyes at other sites were close to the nerve: 3.1 ± 1.00 mm (black), 3.6 ± 1.14 mm (blue), and 4.05 ± 1.28 mm (green). Conclusions Regardless of the injection site, all dyes were close the pudendal nerve, indicating accuracy. We observed wide variation in the dye distribution even though all injections were performed by the same provider, implicating lack of precision. Based on our findings, we propose that the most effective injection location is at the ischial spine because it is the closest to the pudendal nerve; however, all injections were within 4 mm of the pudendal nerve, suggesting that only 1 to 2 injections may be sufficient. |
| Databáze: | OpenAIRE |
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