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Pudendal Nerve Block
Giorgio Ivani
Valeria Mossetti
Patient Position: The patient lies supine.
Indications: Anesthesia of the posterior part of the scrotum.
Needle Size: A very short beveled needle.
Volume: 0.1 mL/kg of ropivacaine 0.2% for children up to 7 years, levobupivacaine 0.5% for older children, up to 5 mL per side.
Anatomic Landmarks: Ischial tuberosity.
Approach and Technique:
The patient is supine with the knees flexed and the plantar part of his
feet joined. Mark the skin projection of the ischial tuberosity on both
sides. At this level a very short beveled needle is inserted in a
medial direction until a loss of resistance corresponding to the
piercing of the obturator fascia is felt.
Tips- This block is particularly useful to complete anesthesia following ilioinguinal/iliohypogastric nerve block when the posterior part of the scrotum is involved in surgery.
Suggested Reading
Dalens B, ed. Regional anaesthesia in infants, children and adolescents. Baltimore: Williams & Wilkins, 1995.