Résumé
Le bloc pudendal consiste à infiltrer les branches périnéale et rectale inférieures du nerf pudendal avec une solution d’anesthésique local de longue durée d’action. L’injection bilatérale est précédée d’un repérage des troncs nerveux à l’aide d’un neurostimulateur qui provoque une contraction du sphincter anal. Elle est complétée par une infiltration de l’espace présacré. Le bloc pudendal permet une analgésie de plusieurs heures et améliore le confort des patients en évitant le recours aux opiacés associés à des effets secondaires (constipation — rétention d’urines) particulièrement gênant dans ce type de chirurgie.
Abstract
The pudendal block consists in injecting a long-acting local anaesthetic into the area around the lower perineal and rectal branches of the pudendal nerve. The bilateral injection is preceded by the location of the nerve trunks using a nerve stimulator, which stimulates contraction of the anal sphincter. The procedure is then completed by infiltration of the presacral space. The pudendal block achieves pain relief for several hours and increases patient comfort by avoiding the use of opiates associated with adverse effects that are particularly troublesome in this type of surgery, such as constipation and urine retention.
Références
Recommandations pour la pratique clinique sur le traitement de la maladie hémorroïdaire (2000), www.snfcp.org
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Vinson-Bonnet, B. Le bloc pudendal: technique d’analgésie postopératoire en chirurgie proctologique. Pelv Perineol 2, 180–183 (2007). https://doi.org/10.1007/s11608-007-0103-7
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DOI: https://doi.org/10.1007/s11608-007-0103-7