Pudendal nerve block in obstetrics is not new. King1 described its use in 1916. DeLee made this statement in 1937: "Local anesthesia is very simple and can be used by any doctor with ordinary ability."2 More recent authors have written of its use in cervical dystocia3 and breech as well as normal deliveries.4
The early accounts of the procedure described two or four sites of injection. The technic here described is a modification which is simpler, gives better results and is suitable in the present concept of painless labor and deliveries.
With the patient in lithotomy position, prepared and draped for delivery, a wheal is raised in the midline of the perineum about 1.5 cm. posterior to the vagina. All injections are carried out through this site with a 4 inch (10 cm.) 20 gage or spinal needle attached to a 30 cc. syringe filled
Johnson OJ. NERVE BLOCK IN PAINLESS CHILDBIRTH. JAMA. 1951;145(6):401-402. doi:10.1001/jama.1951.72920240003009a