Ultrasound or CT guided pudendal nerve block

This is an area to share and learn about new Medical Advances and Techniques where we can be educated and educate.

Ultrasound or CT guided pudendal nerve block

Postby Haydock » Thu Oct 19, 2017 4:14 pm

Which is the more effective in terms of lasting relief?
Haydock
 
Posts: 4
Joined: Sun Oct 01, 2017 3:10 pm

Re: Ultrasound or CT guided pudendal nerve block

Postby stephanies » Fri Oct 20, 2017 3:34 am

I don't think I have ever had an ultrasound guided block, but I have had about six CT or MRI guided blocks in the last decade or so. My longest lasting block was about 18 hours. I don't think the manner in which they visualize the space they are placing the block matters in how long it lasts. For the overwhelming majority of pudendal nerve patients pain relief from blocks is quite temporary, measured in hours. Good luck with your block.
PN started 2004 from fall. Surgery with Filler Nov. 2006, Dr. Campbell April 2007. Pain decreased by 85% in 2008 (rectal and sitting pain resolved completely), pain returned in 12/13.
stephanies
 
Posts: 523
Joined: Mon Oct 25, 2010 3:07 am

Re: Ultrasound or CT guided pudendal nerve block

Postby Haydock » Fri Oct 20, 2017 3:02 pm

stephanies wrote:I don't think I have ever had an ultrasound guided block, but I have had about six CT or MRI guided blocks in the last decade or so. My longest lasting block was about 18 hours. I don't think the manner in which they visualize the space they are placing the block matters in how long it lasts. For the overwhelming majority of pudendal nerve patients pain relief from blocks is quite temporary, measured in hours. Good luck with your block.


Thanks for your response. I'm relatively new to this

I had thought that if the block contained just anaesthetic - that was for diagnostic purposes

But if the block contained anaesthetic plus steroid then that would, hopefully, provide relief that might last months, or longer. I've just been quoted $1200 dollars for a consultation and block in the UK. I don't want to pay all that money to confirm what I'm sure I've already got, which would only provide hours of relief and which wouldn't really go anywhere. I've spent enough money on Consultants as it is
Haydock
 
Posts: 4
Joined: Sun Oct 01, 2017 3:10 pm

Re: Ultrasound or CT guided pudendal nerve block

Postby Violet M » Sun Oct 22, 2017 5:41 am

The advantage of ultrasound guidance is that you aren't exposed to the radiation of a CT scan, which can be significant. If I had a choice, I would go for the ultrasound.

Nerve blocks are controversial in that they sometimes make people worse and I don't personally know very many people who had long-term relief from them. If you have tried conservative therapies and they failed, then I think it is reasonable to try a nerve block, especially if your symptoms and diagnosis are pointing pretty clearly toward PN and your quality of life is bad enough that you are willing to pursue some more invasive therapies. If you symptoms are clearly suggestive of pudendal nerve entrapment as described in the Nantes criteria and you are considering possible surgery, then it would make sense to try nerve blocks before surgery, for sure.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
User avatar
Violet M
 
Posts: 5462
Joined: Mon Sep 06, 2010 6:04 am
Location: United States

Re: Ultrasound or CT guided pudendal nerve block

Postby lightmail » Sun Nov 05, 2017 5:57 am

Violet , do you mean nerve block with steroid before surgery? Or nerve block without steroids before surgery. I think I am close to surgery. Do the surgeons want steroids or just diagnostic blocks. Thanks.
lightmail
 
Posts: 91
Joined: Mon Sep 12, 2011 6:19 am

Re: Ultrasound or CT guided pudendal nerve block

Postby Violet M » Mon Nov 06, 2017 6:26 am

I'm not sure if they would do them without steroids before surgery. It might depend on the doctor and how much success they have had with steroid blocks.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
User avatar
Violet M
 
Posts: 5462
Joined: Mon Sep 06, 2010 6:04 am
Location: United States

Re: Ultrasound or CT guided pudendal nerve block

Postby lightmail » Wed Jan 03, 2018 1:41 pm

Violet, went ahead after 6.6 years and had the lidocaine, and marcaine only diagnostic blocks and now I am worse. What could have happened? My surgeon and studies out of France say the steroids are pretty much useless. I know you have told others that it's probably a flare. Can that happen with a diagnostic block as well. I also have heard you say that some get worse. My sit bones seem affected as well as way more rectal pain. I don't know what to do. I have no rectum for suppositories.. I thought I could take the chance but I was wrong.
lightmail
 
Posts: 91
Joined: Mon Sep 12, 2011 6:19 am

Re: Ultrasound or CT guided pudendal nerve block

Postby Violet M » Thu Jan 04, 2018 5:52 am

Lightmail, how long ago did you have the blocks?

I'm not sure what might have happened but I'm sorry to hear you are having a bad reaction. Hopefully what you are experiencing is a temporary flare-up. In the meantime, maybe you can try the alternating warm/cold sitz baths that I posted about in the following thread: viewtopic.php?f=25&t=5267
This type of hydrotherapy brings fresh blood to the site for improved healing.
Also maybe you can increase you pain meds temporarily.

I vaguely remember a discussion we had recently about possible nerve irritation from lidocaine nerve blocks but I can't seem to find the discussion or the article that was posted. If I run across it I will post it.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
User avatar
Violet M
 
Posts: 5462
Joined: Mon Sep 06, 2010 6:04 am
Location: United States


Return to MEDICAL ADVANCES & EDUCATION

Who is online

Users browsing this forum: No registered users and 1 guest