Disclosures: Mathieu Boudier-Reveret, MD, FRCPC: Nothing to disclose

Objective: To investigate the accuracy and reliability of US-guided injection of the PN at the ischial spine and Alcock canal levels. Since these are US-guided infiltration techniques with a high level of difficulty, this study also compared the accuracy of the infiltrations of three sonographers with different levels of experience.

Design: An experimental cadaveric case series.

Setting: Anatomy laboratory

Participants: Three physiatrists trained in musculoskeletal US imaging with 12, 5 and 1 years of experience carried the injections.

Interventions: Each physiatrist injected a 0.1-mL bolus of colored dye in both hemipelvises of each cadaver at the ischial spine and Alcock canal levels under US guidance. Each cadaver received a total of 6 injections (three injections per hemipelvis). The accuracy of the injection was determined following hemipelvises dissection by an anatomist.

Main Outcome Measures: The accuracy of the US-guided injection of the pudendal nerve.

Results: The injections were accurate 32 times of the total 42 attempts, resulting in a 76% accuracy. Sixteen of 21 injections at the ischial spine level were on target (76% accuracy), while the approach at Alcock canal level yielded 17 successful injections (81% accuracy); however the difference was not statistically significant. There was also no significant difference in accuracy between all operators.

Conclusions: US-guided injection of the PN can be performed accurately at both ischial spine and Alcock canal levels. Injections at the Alcock canal were likely to be more accurate.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/accuracy-of-ultrasound-guided-pudendal-nerve-block-at-the-ischial-spine-and-alcock-canal-levels-a-cadaveric-case-study/