Nerve block help

[Question]

Hi - I had a pudendal nerve block a couple of days ago at the Ischial Spine and so far not much difference apart from a bit of numbness post op. Is this normal?

[Faith]

My experience was numbness for about 5 hours since they used bupivicaine (a longer acting anesthetic), but I had no lasting relief from either of my blocks (they were done at alcock's canal). In fact I flared pretty bad after one of my blocks. I think most people on here do not have a great response to blocks unfortuantely. PN blocks are becoming more of a diagnostic tool than an actual treatment for PN or at least for true PNE.

[Violet M]

So, when you say numbness post-op, do you mean that after the block you were numb for a little while? Was your pain improved temporarily too?

If you have even a short time of relief immediately after a nerve block that is diagnostic that the pudendal nerve is likely the source or at least one of the sources of your pain.

[Question]

Hi - not quite sure to make it. I was numb in the the genital area for about an hour afterwards but wore off pretty quick. Not sure whether that was because of the anesthetic or anti-inflammatory. My bottock pain and pernium pain only really come on when I am sitting and sometimes lying down. Since I was walking or lying down afterwards, I never got to work out really whether it had made a difference. A couple of days later I was back to normal pain wise - not much better or worse.

[Violet M]

Hi Question,

I guess that is a bit of a mystery if you were not able to try sitting afterward to see if the block helped. Typically there is a numbing agent like marcaine in the blocks that lasts up to a few hours and is for diagnostic purposes. If the pain is relieved and you have numbness in the PN distribution area for a short time after the block, that can be an indication that you have pudendal neuralgia. The anti-inflammatory (steroid) usually kicks in several days later and may either give you more long-lasting relief or it can cause a flare-up for several weeks.

Violet

[carolynm]

Tomorrow will get an U/s guided injection at pudendal nerve and a trigger point inj at obturator internus. Dr. Hanson says if it numbs the pain, we have a good shot at letting the cortisore work at that site. If I don't get relief, the cause is most likely from Alcock's canal.

So depressing.

All from using a pickaxe in the yard. It just doesn't add up.

Thoughts anyone?

thanks,
cari

[carolynm]

Nerve block didn't help. Damn. Must be Alcock's canal. Dr. Hanson wants to try to inject w/ultrasound in the lithotomy position in a couple of weeks. I will be his guinea pig.

MRI with Potter in September.

Ugh.

cari

[helenlegs 11]

He does seem to be doing the right thing by trying to eliminate separate areas of entrapment which is great to be able to narrow it down. It will then be interesting to see if that all matches up with Dr Potters scan in September.
Having all of that combined information can only be a good thing, especially if it all adds up and confirms a diagnosis.
Had too google the lithotomy position. but I guess we've nearly all been there at one time or another .
Have we got your Dr Hanson on the home page list ? ?
Hope you get some better results soon.

[carolynm]

Thanks for your reply, Helen. It means so much to me to have others on here that CARE!!!!

cari

[Violet M]

So sorry, Cari, that the block didn't help. The time it takes to get the diagnosis figured out can be very frustrating.