Intraoperative esmolol infusion reduces morphine requirements and provides more effective analgesia compared with a combination of remifentanil-ketamine given by infusion in patients undergoing LC.

Introduction: Pudendal nerve blocks have a wide range of clinical applications for the management of acute post-operative pain in urologic, gynecological surgery, in coloproctology, as well as in pain medicine for differential diagnosis, and for the management of pudendal neuropathies. However, despite its benefits it is infrequently used.Objective: To perform a detailed description of the most recent ultrasound-guided techniques with the aim of encouraging safe and reproducible learning. Materials and methods:We have performed a broad, non-systematic review of the literature through Medline, Embase and Science Direct between 1985 and 2016, to evaluate the most relevant articles, using the following key words: pudendal nerve anatomy, pudendal nerve, pudendal nerve blocks, pudendal nerve ultrasound, pudendal neuralgia, nerve entrapment, chronic pain, Alcock canal, and pelvic pain. The search was limited to articles published in Spanish, English and French.Results: Recent descriptions were found of a large number of anatomic variants, which are described in detail and shown in graphic documents in order to facilitate the sonoanatomic correlation of nerve location as a guide for the performance of the pudendal nerve block through the different approaches.

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