US pudendal

[bedrock]

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can anyone recommend some good resources for learning US guided pudendal blocks?

Due to Covid, courses aren’t an option. I’m thinking books, particularly good videos, etc. Any recommendations would be appreciated.

My US skills are modest, if that makes a difference.

 

[SSdoc33]

good for you for delving into this skill set

ligament can tell you

calling ligament?

 

[Baron S]

Doesn't answer your question(sorry), but its a very easy fluoro injection if that's an option.

 

[painfree23]

Doesn't answer your question(sorry), but its a very easy fluoro injection if that's an option.

Details?

 

[Ferrismonk]

Amazon product ASIN 1451186703
This book is invaluable. If you're interested in ultrasound blocks, get it.

 

[SommeRiver]

The fluoro option takes 90 sec

 

[lobelsteve]

Fluoro: start inferior to falciform. Touch on lowest point, turn deep for a few mm, rotate under falciform. Squirt in omnipaque.

 

[Agast]

Pudendal Nerve Block - Anesthesia Key

CHAPTER 62 Pudendal Nerve Block Susanti Chowdhaury, Gail Gray, and Andrea Trescot Pudendal pain can often be difficult to diagnose and harder to treat. The majority of patients suffering from this malady are female; chronic pelvic pain affects approximately 1 in 7 women.1 Frequently, they have...

aneskey.com

Instructions for fluoro guided block

 

[Cholula]

The Atlas of Ultrasound-Guided Procedures in Interventional Pain Management by Narouze has 3 pages on US guided pudendal blocks and couple of US images too.

 

[oreosandsake]

are we facebook friends? there are some great videos shared.

once you see the nerve between the sacrotuberous and sacrospinous ligaments your life will change. hypothetically if this is the most common entrapment site, hydrodissection between the ligaments in lieu of volume and periphery block would actually be therapeutic.

 

[Orin]

can anyone recommend some good resources for learning US guided pudendal blocks?

Due to Covid, courses aren’t an option. I’m thinking books, particularly good videos, etc. Any recommendations would be appreciated.

My US skills are modest, if that makes a difference.

Regional anesthesia guided by ultrasound in the pudendal nerve territory - This is a nice paper with good figures of anatomy and where to place the probe/etc
Feasibility of Real-Time Ultrasound for Pudendal Nerve Block in Patients with Chronic Perineal Pain | Regional Anesthesia & Pain Medicine - This has better U/S images but less probe positioning/anatomy/etc

- Quick U/S video

 

[Baron S]

Pudendal Nerve Block - Anesthesia Key

CHAPTER 62 Pudendal Nerve Block Susanti Chowdhaury, Gail Gray, and Andrea Trescot Pudendal pain can often be difficult to diagnose and harder to treat. The majority of patients suffering from this malady are female; chronic pelvic pain affects approximately 1 in 7 women.1 Frequently, they have...

aneskey.com

Instructions for fluoro guided block

This is exactly how I do it(pic from your source). Patient lies prone, oblique ipsilateral until you can see ischial spine, straight trajectory view and inject.

 

[lobelsteve]

View attachment 318007

This is exactly how I do it(pic from your source). Patient lies prone, oblique ipsilateral until you can see ischial spine, straight trajectory view and inject.

Looks like you are smokin a doobie with a roach clip. Blowing smoke on the pudendal.

 

[painfree23]

View attachment 318007

This is exactly how I do it(pic from your source). Patient lies prone, oblique ipsilateral until you can see ischial spine, straight trajectory view and inject.

U hit the ischial spine?

 

[painfree23]

Do you typically burn it? Pulsed?

 

[Baron S]

Touch down on ischial spine, can walk off edge a bit if you like, inject.

Would consider pulsing it but never have. Wouldn't burn it, pudendal nerve wayyyy too important. Responsible for urinary and fecal continence and genital sensation. Can't think of a quicker way to get a patient to hate you than screwing with those functions.

 

[painfree23]

Touch down on ischial spine, can walk off edge a bit if you like, inject.

Would consider pulsing it but never have. Wouldn't burn it, pudendal nerve wayyyy too important. Responsible for urinary and fecal continence and genital sensation. Can't think of a quicker way to get a patient to hate you than screwing with those functions.

do you do bilateral?

 

[NOSfan]

Article attached.

 

[pastafan]

Have pulsed with good results after previous block. Very happy patients.