Recent anatomical insights have underscored the critical role of the ventral clitoral nerve branches in maintaining the integrity of the female sexual response.
Historically, anesthetic approaches in this region have been characterized by a "blind" or non-selective infiltration, which often lacks the precision required to target specific neural pathways. This lack of selectivity not only risks inadequate analgesia but also increases the potential for iatrogenic injury to the primary neurovascular structures. The objective of this study is to present and validate a targeted subclitoral anesthetic technique that offers superior selectivity, providing a reliable analgesic block while safeguarding the complex neurofunctional architecture of the clitoris. The ventral clitoral nerves emerge as terminal branches of the dorsal nerve of the clitoris. These fibers distribute extensively along the ventral surface of the clitoral glans and body, culminating in a dense subepithelial network that is highly accessible to targeted infiltration (Fig 1).

We conducted a clinical evaluation of 50 patients (ages 26–65) undergoing intimate surgical procedures. A standardized protocol was implemented using 1.8 mL of lidocaine with epinephrine, administered at a targeted depth of 1–1.5 cm in the subclitoral midline. Pain efficacy was measured via the Visual Analog Scale (VAS). The efficacy of this method relies on strict adherence to a standardized delivery protocol designed to maximize nerve contact while minimizing trauma.
Standardized Anesthetic Protocol
Parameter	Specification
Patient Position	Lithotomy
Anesthetic Agent	Lidocaine with epinephrine
Injection Volume	1.8 mL
Target Depth	1.0–1.5 cm
Surgical Approach	Midline subclitoral insertion (Fig.2)
Population Demographics: A total of 50 female patients was enrolled fro November 2025 to March 2026. All patients signed inform consent. The protocol was successfully implemented in a cohort of 50 patients, with ages ranging from 26 to 65 years.
Surgical Procedures: The technique was utilized along with local anesthetics as a block for the following intimate surgeries:
•	Clitoroplasty (n=30)
•	Luksenburg Plus procedure (n=20)
•	
Outcome Measures: Analgesic success was quantified using the Visual Analog Scale (VAS), capturing both intraoperative comfort and immediate postoperative pain levels.

All 50 procedures were completed with effective local anesthesia. The mean VAS score was 3, which represents a highly tolerable patient experience and confirms the technique's clinical utility in sensitive intimate reconstructions.
Safety Profile:
1.	Zero instances of vascular injury or hematoma formation.
2.	Total absence of postoperative neurological deficits or sensory loss.
3.	High procedural reproducibility, with consistent results across the entire age and procedural spectrum.

 There were no recorded instances of vascular injury or long-term neurological complications, demonstrating high procedural safety.

This technique finds its scientific validation in the work of Lee et al. (2026), whose advanced imaging and mapping of the clitoral nerve network have redefined the clitoris as a sophisticated "integrated orgaOur findings suggest that the 1–1.5 cm infiltration depth is the "anatomical sweet spot."  This precision is vital for minimizing iatrogenic risk and preserving the patient’s long-term sexual and sensory function.

Subclitoral anesthetic infiltration is an innovative, safe, and minimally invasive advancement for intimate surgeries. By standardizing the procedure to a volume of 1.8 mL and a depth of 1–1.5 cm, surgeons can achieve high-quality analgesia with exceptional reproducibility. This technique ensures that the pursuit of aesthetic and reconstructive goals does not come at the cost of functional or sensory integrity.
The absence of vascular complications and neurological deficits in all 50 cases reinforces the safety of the method. Importantly, the low VAS score suggests that effective analgesia can be 
Its simplicity and low learning curve further support its adoption in routine clinical practice.

Lee JY, et al. Neuroanatomy of the clitoris: comprehensive mapping of nerve networks using advanced imaging. bioRxiv. 2026;2026.03.18.712572. doi:10.64898/2026.03.18.712572v1.
Steers WD. Neural pathways and central sites involved in penile erection: preparation for a new era in female sexual function. World J Urol. 2002;20(2):68-74.
O’Connell HE, DeLancey JO, Haslam SI, et al. Anatomy of the clitoris. J Sex Med. 2008;5(8):1883-1891.