Obstetric anaesthesia: pudendal nerve block: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Obstetric anaesthesia: pudendal nerve block

Sample item

A pudendal nerve block for the second stage of labour is administered transvaginally. Which landmark is used?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Ischial spine

The pudendal nerve (S2 to S4) passes around the ischial spine and sacrospinous ligament, where local anaesthetic is deposited. The block provides perineal analgesia for delivery and episiotomy repair. It does not relieve uterine contraction pain.

Option by option

  • A. Ischial spine (correct)

    Correct. The needle is guided to the ischial spine and sacrospinous ligament.

  • B. Anterior superior iliac spine

    The anterior superior iliac spine is used for other blocks such as the ilioinguinal nerve.

  • C. Pubic symphysis

    The pubic symphysis is not the site of the nerve.

  • D. Coccyx tip

    The coccyx is not the landmark for the block.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Ischial spine. The pudendal nerve (S2 to S4) passes around the ischial spine and sacrospinous ligament, where local anaesthetic is deposited.

Why is "Anterior superior iliac spine" not the answer?

The anterior superior iliac spine is used for other blocks such as the ilioinguinal nerve.

Why is "Pubic symphysis" not the answer?

The pubic symphysis is not the site of the nerve.

Why is "Coccyx tip" not the answer?

The coccyx is not the landmark for the block.

What concept does this question test?

It tests Obstetric anaesthesia: pudendal nerve block in Anaesthesia. The block provides perineal analgesia for delivery and episiotomy repair. It does not relieve uterine contraction pain.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Obstetric anaesthesia: pudendal nerve block?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.