[Pudendal nerve block for perineo-vulvar surgery: monocentered prospective and randomised study]

Area of Science:

• Anesthesiology
• Surgical Pain Management

Background:

• Perineal and vulvar surgeries often require effective pain management strategies.
• General anesthesia alone may not fully address intraoperative and postoperative pain.
• Pudendal nerve block is a regional anesthesia technique that can be explored for these procedures.

Purpose of the Study:

• To evaluate the effectiveness of pudendal nerve block in improving analgesia quality during and after perineal or vulvar surgery.
• To compare pain scores and analgesic consumption between general anesthesia alone and combined general anesthesia with pudendal nerve block.

Main Methods:

• A prospective, randomized, monocentric study involving patients undergoing perineo-vulvar surgery.
• Two groups were compared: general anesthesia (GA) and general anesthesia with bilateral nerve stimulator-guided pudendal nerve block (PB).
• Pain was assessed using the Visual Analogic Scale (VAS) in the first 24 hours postoperatively; analgesic consumption was also recorded.

Main Results:

• No significant difference in mean VAS pain scores was observed in the first 24 hours between the groups.
• A decrease in VAS pain scores at 2 hours postoperatively was noted in the pudendal nerve block group.
• Analgesic consumption during surgery was reduced in the pudendal nerve block group, with no reported complications.

Conclusions:

• Nerve stimulator-guided pudendal nerve block is a simple and useful adjunct to general anesthesia for perineal or vulvar surgery.
• It can decrease intraoperative analgesic requirements and immediate postoperative pain without complications.
• Further research is warranted to confirm efficacy and evaluate cost-effectiveness.