Article ID: 19-0020
Herein, we report a case of perineal pain in which saddle block with a hyperbaric tetracaine solution was effective. The patient developed interstitial cystitis and dysuria from a neurogenic bladder and experienced severe perineal pain during self-urination. Treatment with analgesics, sympathetic block, and nerve root block were ineffective. Therefore, the subarachnoid saddle block was performed using tetracaine dissolved in 20％ glucose solution. Although a sustained analgesic effect was not obtained with the 0.5％ solution, good analgesia on a monthly basis was obtained when 1.0％ solution was used. Since tetracaine is a powder formulation, it is possible to adjust the concentration such that there is no bladder or rectal disturbance. Moreover, because the analgesic effect of tetracaine is reversible, it can be a useful tool for analgesia in the perineal region when nerve destruction of phenol glycerin is a contraindication.
