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Abstract Introduction The use of regional anesthetic block has increased, along with the reduction of the use of spine anesthetic in this particular field of surgical activity. In the last decade ambulatory surgery and local anesthetic have lower surgical time, complications of the anesthetic itself, and hospital stay. Objective Presenting the results obteained with the use of local anesthesic and analgesic in the resolution of benign anorectal pathology. Methods A prospective, longitudinal, study, from January 2017 to December 2017, patients were classified according to surgical procedures performed using analogical visual scale to determine the pain tolerance, during the procedure, 24 h later and in the 5th post operative day. Results 253 procedures were performed with 116 local analgesia, 116 were male (45.86%) years 137 female (54%), Milligan-Morgan hemorroidectomy with Ligasure and fistulotomy were the most frequently performed procedures 32% each, followed by biopsy 16%, left lateral esfinterotomy 13% and cutaneous appendix 12%. Females presented better pain tolerance than males patients (92 vs. 81), 68% referred good tolerance through the procedure. Conclusions 68% of all the patients obtained good pain tolerance through anal anesthetic block, females manifested better pain tolerance than males, in non-complicated anorectal pathology local block ha shown to be safe and reproductible for the treatment of benign anorectal pathology in the Guatemalan Institute for Social Security.
Resumo Introdução O uso de bloqueio anestésico regional aumentou ao mesmo tempo em que diminuiu o uso do anestésico espinhal nesse campo específico da atividade cirúrgica. Na última década, a cirurgia ambulatorial e o anestésico local apresentaram um tempo cirúrgico menor, menos complicações associadas ao próprio anestésico e redução da permanência hospitalar. Objetivo Apresentar os resultados obtidos com o uso de anestésico local e analgésico na resolução da patologia anorretal benigna. Métodos Estudo prospectivo, longitudinal, realizado no período de janeiro a dezembro de 2017. Com o uso de uma escala visual analógica, os pacientes foram classificados para determinar a tolerância à dor durante o procedimento, 24 horas após a cirurgia e no quinto dia de pós-operatório. Resultados No total, 253 procedimentos foram realizados com 116 analgesias locais; 116 pacientes eram do sexo masculino (4586%) e 137 do sexo feminino (54%). A técnica de Milligan-Morgan para hemorroidectomia com ligadura e a fistulotomia foram os procedimentos realizados com mais frequência (32% cada), seguidos de biópsia (16%), esfincterotomia lateral esquerda (13%) e apêndice cutâneo (12%). As mulheres apresentaram melhor tolerância à dor que os homens (92 vs. 81), e 68% apresentaram boa tolerância durante o procedimento. Conclusões De todos os pacientes, 68% apresentaram boa tolerância à dor com o uso de bloqueio anestésico por via retal; as mulheres manifestaram melhor tolerância à dor que os homens. Na patologia anorretal não complicada, o bloqueio local mostrou ser seguro e reprodutível para o tratamento da patologia anorretal benigna no Instituto Guatemalteco de Seguridade Social.
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Humans , Male , Female , Rectal Diseases/surgery , Ambulatory Surgical Procedures , Anesthetics, Local , Pain, Postoperative , Rectal Diseases/rehabilitation , Pain MeasurementABSTRACT
Introduction:DVIU is a common urological procedure forshort segment urethral stricture ≤2cm and is generally doneunder spinal anesthesia. The study was performed to accessthe feasibility to perform DVIU under local anesthesia toreduce the cost, hospital stay and the morbidity of anaesthesia.Material and Methods: A prospective randomized study wasconducted in 168 patients who were divided in two groups.Group ‘a’ received only ICS block intra corporospongiosalblock) and group ‘b’ received both ICS with USblock(urethrosphincteric block).VAS pain score was obtainedat the end and one hour after the procedure.Results: The visual analogue score (VAS) at the time ofprocedure were significantly lower for Group ‘b’ (Groupa =3.46, Group b=2.55 p value=0.0053), and was alsolower at the end of one hour (Group a=3.1, Group b=2.01 pvalue=0.0001). The change in blood pressure and pulse rateas a measure of hemodynamic variability were recorded inboth groups and significant differences were noted at the timeof procedure Group ‘a’ 6.43±1.08, Group ‘b’ 3.95±1.46, p <0.0001 value.Conclusion: DVIU is a common urological procedure whichcan be safely performed under local anaesthetic blocks insteadof spinal anaesthesia. A combination of ICS with US blockincreases the safety and tolerability of the procedure.
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Objective To observe clinical curative effect of the external application of Wentong Paste plus local block therapy for the treatment of stenosing tendovaginitis at radial styloid. Methods A total of 108 cases of patients with stenosing tendovaginitis at the radial styloid were randomly divided into local block therapy group, combination group and Wentong Paste group, 36 cases in each group. The local block therapy group was given injection of blocking liquid into the tendon sheath, combination group was given external application of Wentong Paste(mainly composed of Radix Angelicae Sinensis, Fructus Psoraleae, Radix Angelicae Pubescentis, and Rhizoma et Radix Notopterygii) plus local block therapy, and Wentong Paste group was only given external application of Wentong Paste. Before treatment and after treatment for one and 2 week(s), visual analogue scale (VAS) scores of pain and range of motion (ROM) of wrist joint were observed for the evaluation of clinical effectiveness and safety. The patients were followed up for 3 months for the assay of recurrence rate. Results (1) After treatment for one week, the total effective rate of local block therapy group, combination group and Wentong Paste group was 77.8%, 100.0%, 72.2%respectively, and the total effective rate after treatment for 2weeks was 86.1%, 100.0%, 86.1% respectively. The combination group had better clinical efficacy than local block therapy group and Wentong Paste group (P < 0.05). (2) After treatment for one and 2 week (s), VAS scores of the 3 groups were obviously increased while ROM was much increased (P < 0.05 compared with those before treatment). The combination group had the lowest VAS scores and highest ROM(P < 0.05).(3) No adverse reaction was found in the 3 groups during the treatment. (4) The 3 month follow-up results showed that the recurrence rate of the three groups was 30.61%, 10.20%, 20.41% respectively, and the combination group had the lower rate than local block therapy group and Wentong Paste group(P<0.05). Conclusion The external application of Wentong Paste plus local block therapy is effective for the treatment of stenosing tendovaginitis at radial styloid by relieving pain, increasing the ROM, and reducing the recurrence rate. The one-week efficacy of Wentong Paste alone was inferior to that of local block therapy alone, but their two-week efficacy showed no obvious difference. Moreover, Wentong Paste has an obvious advantage in reducing the recurrence rate.
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Objective To investigate the effect of Tennis Elbow treated with Chinese manipulation.Methods 150 patients of Cervical SpondyIosis were randomly recruited into a treatment group(n=100)and a control group(n=50).The the effects after the treatment.Resuits The toalal effective rate of 100%in the treatment group.compared witIl 54%in the control group.showed statistical significance(P＜0.01).Condusion The ChiBese manipulation is more effective than local block therapy in treating tennis elbow.
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0.05),indicating that two groups had the similar effect on relieving pain.VAS score in both groups was markedly decreased after treatment(P0.05).Conclusion Acupuncture is effective in the treatment of lumbodorsal myofascial pain syndrome,and its effect is similar to that of local block of trigger points with lidocaine.Acupuncture has less side effect.