Masaji Utsu1, Yuichiro Kato1, Kei Takehara1 and Kazuo Maeda2*
1Department of Obstetrics and Gynecology, Seirei Mikatahara hospital, Hamamatsu, Japan
2Department of Obstetrics and Gynecology, Tottori University Medical School (Emeritus), Yonago, Japan
Received: 23 June, 2016; Accepted: 11 July, 2016; Published: 12 July, 2016
Kazuo Maeda, Department of Obstetrics and Gynecology, Tottori University Medical School (Emeritus), Yonago, Japan 3-125, Nadamachi, Yonago, Tottori, 683-0835, Japan, Tel: 81-859-22-6856; Fax: E-mail:
Utsu M, Kato Y, Takehara K, Maeda K (2016) Safe Labor Analgesia with Vaginal Submucosal Injection and Pudendal Nerve Block. Glob J Anesthesiol 3(1): 011-013. DOI: 10.17352/2455-3476.000024
© 2016 Utsu M. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Labor; Anesthesia; Vaginal submucosal injection; Pudendal nerve block; No adverse effect
Aims: As old paracervical block using Kobak needle (Atom Medical, Tokyo, Japan) abondoned developing fetal bradycardia, new safe vaginal submucosal anesthesia was tried to safely remove labor pain.
Methods: Three ml local anesthetics was injected to vaginal submucosal tissue with 2 mm exposed 22G 14 cm long Cathelin needle (Hakko, Nagano, Japan), and 5 mm exposed needle injecting 7-10ml anesthetics to block pudendal nerve.
Results: Analgetic and relaxation effects were sufficient, despite no fetal and maternal damage was experienced among 4,070 cases of anesthesia in 6,976 births. Local anesthesia was repeated if it was necessary.
Conclusion: Anesthesia technique was simple and analgesia effect was sufficient. No adverse effect developed due to shallow injection of small amount of local anesthetics. Vaginal delivery was promoted, and teminal fetal heart rate abnormality reduced due to the decreased resistance of birth canal, which resulted the reduction of emergency cesarean section.
Vaginal submucosal Injection of local anesthetic materials was one of labor pain analgesia, and the paracervical block anesthesia using Kobak needle was one of them in the past [1,2], but contraindicated due to frequent reports of its side effect on the development of fetal bradycardia , fetal death  and hazardous animal experiment , where pudendal nerve block is still supported by some authors [6-8].
The paracervical block using Kobak needle used in past paracervical block (Figure 1) was disadvantageous because of several reasons as follows;