Ultrasound-Guided Pudendal Nerve Block at the Entrance of the Pudendal (Alcock) Canal: Description of Anatomy and Clinical Technique

Regional Anesthesia and Pain Medicine
Thomas Fichtner BendtsenJens Børglum

Abstract

Ultrasound-guided techniques for pudendal nerve block have been described at the level of the ischial spine and transperineally. Theoretically, however, blockade of the pudendal nerve inside Alcock canal with a small local anesthetic volume would minimize the risk of sacral plexus blockade and would anesthetize all 3 branches of the pudendal nerve before they ramify in the ischioanal fossa. This technical report describes a new ultrasound-guided technique to block the pudendal nerve. The technique indicates an easy and effective roadmap to target the pudendal nerve inside the Alcock canal by following the margin of the hip bone sonographically along the greater sciatic notch, the ischial spine, and the lesser sciatic notch. The technique was applied bilaterally in 3 patients with chronic perineal pain. The technique described was also used to locate the pudendal nerve within Alcock canal and inject dye bilaterally in 2 cadavers. Complete pinprick anesthesia was obtained in the pudendal territory of the perineum in all 3 patients. Pain was effectively alleviated or reduced in all patients with no affection of the sacral plexus nerve branches. In the 2 cadavers, all 4 pudendal nerves were successfully targeted and colored. This n...Continue Reading

References

Jan 1, 1986·International Journal of Colorectal Disease·S J SnooksM Setchell
May 5, 1999·Abdominal Imaging·D ThoumasP Freger
Oct 5, 2001·Diseases of the Colon and Rectum·H GruberE Brenner
Oct 5, 2001·Diseases of the Colon and Rectum·P KovacsG Bodner
Jul 24, 2003·AJR. American Journal of Roentgenology·David M HoughStanley J Antolak
Jul 15, 2011·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S-H KimJ K Lee
Mar 21, 2012·Regional Anesthesia and Pain Medicine·Geoff A BellinghamPhilip W Peng
Aug 28, 2013·Surgical and Radiologic Anatomy : SRA·Jens KesslerThomas Grau

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Citations

Aug 5, 2016·Neurourology and Urodynamics·Marko KonschakeReinhold Zimmermann
Apr 6, 2019·The Anatomical Record : Advances in Integrative Anatomy and Evolutionary Biology·Marko KonschakeMarit Zwierzina
Jul 1, 2020·The American Journal of Hospice & Palliative Care·John David PrologoJason W Mitchell
Jul 8, 2020·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Michael G FadelChristos Kontovounisios
Aug 18, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Nicholas S GregoryJennifer M Hah
Sep 3, 2020·International Urogynecology Journal·Eva Uustal
Dec 6, 2017·Paediatric Anaesthesia·Isabelle Gaudet-FerrandChristophe Dadure
May 18, 2018·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A LadhaC Puranik
May 27, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Béatrice SoucyStéphane Sobczak
Mar 18, 2021·Pain Research & Management : the Journal of the Canadian Pain Society = Journal De La Société Canadienne Pour Le Traitement De La Douleur·Jian HeHan B Wang
Feb 17, 2021·Diseases of the Colon and Rectum·Francesco MongelliDimitrios Christoforidis
Nov 21, 2021·Journal of Osteopathic Medicine·Sébastien MurerMarion Kinne

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