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Issue: Vol. 563 No. 2 (2026)
Section: Các bài báo
DOI: 10.51298/vmj.v563i2.18953
Date Published: 05/10/2026
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Đinh, C. L., & Phạm, T. L. (2026). EFFECTIVENESS OF ULTRASOUND-GUIDED PUDENDAL NERVE BLOCK FOR PAIN CONTROL AFTER EPISIOTOMY REPAIR IN WOMEN UNDERGOING VAGINAL DELIVERY. Vietnam Medical Journal, 563(2). https://doi.org/10.51298/vmj.v563i2.18953

EFFECTIVENESS OF ULTRASOUND-GUIDED PUDENDAL NERVE BLOCK FOR PAIN CONTROL AFTER EPISIOTOMY REPAIR IN WOMEN UNDERGOING VAGINAL DELIVERY

Công Luyện Đinh1, , Thị Lan Phạm2
1 Bệnh viện C, Thái Nguyên
2 Trường Đại học Y Dược - Đại học Thái Nguyên

Main Article Content

Abstract

Objective: To evaluate the analgesic efficacy of ultrasound-guided pudendal nerve block in women undergoing vaginal delivery with episiotomy repair at Thai Nguyen C Hospital.


Methods: A randomized controlled clinical trial was conducted on 60 women undergoing vaginal delivery with episiotomy. Participants were randomly allocated into two equal groups. The control group received local infiltration anesthesia with 1% lidocaine, whereas the intervention group underwent ultrasound-guided pudendal nerve block using 0.25% ropivacaine. Analgesic efficacy was assessed by onset time, duration of analgesia, Visual Analogue Scale (VAS) pain scores at rest and during movement, time to first request for rescue analgesia, and the need for additional postoperative analgesics.


Results: The mean procedure time for ultrasound-guided pudendal nerve block was 5.09 ± 0.67 minutes, and the mean skin-to-pudendal nerve distance was 2.95 ± 0.17 cm. The onset time was significantly longer in the pudendal nerve block group than in the control group (7.28 ± 0.71 vs. 1.29 ± 0.16 minutes; p < 0.01). However, the duration of analgesia was significantly prolonged (7.68 ± 0.63 vs. 1.47 ± 0.93 hours; p < 0.01). VAS pain scores at rest were significantly lower during the first 18 hours postpartum, while VAS scores during movement were significantly lower during the first 9 hours in the intervention group (all p < 0.01). Only 2 of 30 women (6.7%) in the pudendal nerve block group required diclofenac compared with 28 of 30 women (93.3%) in the control group. In addition, the time to first request for rescue analgesia was significantly longer in the intervention group (11.8 vs. 7.48 hours; p = 0.023).


Conclusion: Ultrasound-guided pudendal nerve block is an effective analgesic technique following episiotomy repair. It prolongs the duration of analgesia, reduces pain intensity at rest and during movement, and significantly decreases the need for additional postoperative analgesics.

Keywords

Pudendal nerve block, ultrasound guidance, postoperative analgesia, episiotomy, vaginal delivery, ropivacaine

Article Details

References

1. Edqvist, M., Ajne, G., Teleman, P., Tegerstedt, G. & Rubertsson, C. Postpartum perineal pain and its association with sub-classified second-degree tears and perineal trauma-A follow-up of a randomized controlled trial. Acta obstetricia et gynecologica Scandinavica 103, 2314-2323, doi:10.1111/aogs.14938 (2024).
2. Bendtsen, T. F. et al. Ultrasound-Guided Pudendal Nerve Block at the Entrance of the Pudendal (Alcock) Canal: Description of Anatomy and Clinical Technique. Regional anesthesia and pain medicine 41, 140-145, doi:10.1097/aap.0000000000000355 (2016).
3. Aissaoui, Y. et al. A randomized controlled trial of pudendal nerve block for pain relief after episiotomy. Anesthesia and analgesia 107, 625-629, doi:10.1213/ane.0b013e31817ee48f (2008).
4. Bellingham, G. A., Bhatia, A., Chan, C. W. & Peng, P. W. Randomized controlled trial comparing pudendal nerve block under ultrasound and fluoroscopic guidance. Regional anesthesia and pain medicine 37, 262-266, doi:10.1097/AAP.0b013e318248c51d (2012).
5. Yasmine Ellouze et al. Pudendal nerve block versus usual lidocaine infiltration for pain relief in episiotomy repair: a comparative prospective study. Italian Journal of Gynæcology & Obstetrics 36, 173-182 (2024).