Local perianal nerve block versus spinal block for closed hemorrhoidectomy: a ramdomized controlled trial.
Article
in English
| IMSEAR
| ID: sea-39317
ABSTRACT
OBJECTIVE:
To compare analgesic effectiveness, postoperative pain, complications, and patients' satisfaction between two randomly allocated groups--one group that had local perianal nerve block and another group that had spinal block following closed hemorrhoidectomy. MATERIAL ANDMETHOD:
Sixty-seven patients underwent elective hemorrhoidectomy. Of these, 33 were randomly allocated to receive spinal anesthesia (SA) while 34 received perianal local analgesia (LA) with bupivacaine. Pain measurement at 6 and 24 hours following hemorrhoidectomy, the quantity of postoperative analgesic medication administered, patient's satisfaction and complications were recorded.RESULTS:
Among the patients who had SA, there were 5 patients (15.2%) who developed hypotension during surgery. There was no reported case of hypotension among those who had LA. There was no significant difference in degree of median postoperative pain at 6 hours (LA 38 vs. SA 50 with VAS; p = 0.09) and at 24 hours (LA 31 vs. SA 35 with VAS; p = 0.35) between the two groups. Patients had a high satisfaction on both anesthetic methods. Patients in the SA group required more parenteral analgesics (p = 0.03) and had a higher incidence of urinary retention than those in the LA group (SA 30.3% vs. LA 8.8%, p = 0.03).CONCLUSION:
Local perianal nerve block for hemorrhoidectomy is feasible and safe and superior to spinal block due to a lower incidence of post-op urinary retention and less requirement of parenteral analgesics post-op.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Anal Canal
/
Pain, Postoperative
/
Pain Measurement
/
Bupivacaine
/
Female
/
Humans
/
Male
/
Logistic Models
/
Feasibility Studies
/
Multivariate Analysis
Type of study:
Controlled clinical trial
/
Diagnostic study
/
Prognostic study
/
Risk factors
Language:
English
Year:
2008
Type:
Article
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