Bloc du nerf pudendal en chirurgie périnéo-vulvaire : étude monocentrique prospective randomisée

Abstract

ObjectivesEvaluation of pudendal nerve block on the quality of analgesia in perineal or vulvar surgery. Patients and methodsWe realised a monocentered, prospective and randomised study of all patients undergoing perineo-vulvar surgery. Two groups of patients were evaluated: general anaesthesia alone (GA group, 41 patients) and both general anaesthesia and bilateral nerve stimulator-guided pudendal nerve block (15mL of Ropivacaïne 5mg.mL−1+0,5μg.kg−1 of Clonidine) (PB group, 42 patients). Evaluation of pain was realised with per- and post-surgical prescription of hypnotics and antalgics was noted. The primary outcome measure was the Visual Analogic Scale (VAS) pain means scores in the first postoperative 24hours. ResultsThere was no difference in the VAS pain means scores in the first 24hours, but it seemed to have a decrease in VAS pain at 2hours in the PB group. Analgesic consumption during surgery was decreased in the same group. No complication of the pudendal block has been reported. Discussion and conclusionThe nerve stimulator-guided pudendal nerve block is a simple and useful method which can, when associated with general anesthesia, reduce per-operative antalgics consumption and a decrease in the immediate postoperative pain in perineal or vulvar surgery, without complication or lengthening operating time. Further studies are needed to confirm the effectiveness of this technique and evaluate the costs and potential complications.