Pudendal Nerve Block for Pain Relief During Episiotomy Repair

Episiotomy is a surgical cut made in the perineum, the area between the vagina and anus, during vaginal childbirth. Repairing an episiotomy can cause pain, and adequate pain relief is important for maternal comfort during and after delivery. This study will compare two methods of providing anesthesia during episiotomy repair in women undergoing vaginal delivery with a mediolateral episiotomy at the Department of Maternal and Child Health (MCH), Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. A total of 80 eligible women will be enrolled and randomly assigned in equal numbers to two groups. The intervention group will receive a bilateral pudendal nerve block in addition to routine episiotomy repair and standard postpartum pain relief. The control group will receive conventional local anesthetic infiltration around the episiotomy area, along with routine repair and standard postpartum pain relief. Pain will be assessed using a 100-mm Visual Analogue Scale (VAS), on which 0 represents no pain and 100 represents the worst imaginable pain. Pain will be assessed during episiotomy repair and at 1, 3, and 6 hours after delivery. The study will also compare the need for additional pain medication, pain during sitting and walking, patient comfort and satisfaction, the duration of episiotomy repair, the need for additional local anesthetic, and complications associated with the procedures. The aim is to determine whether pudendal nerve block provides better pain relief during episiotomy repair and improves early postpartum comfort compared with conventional local anesthetic infiltration.