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Ischiorectal Block with Bupivacaine for Post Hemorrhoidectomy Pain

  • Rajabi, Mehdi (Departement of Anesthesiology, Kashan University of Medical Sciences) ;
  • Hosseinpour, Mehrdad (Trauma Research Center, Kashan University of Medical Sciences) ;
  • Jalalvand, Faranak (Trauma Research Center, Kashan University of Medical Sciences) ;
  • Afshar, Mohammad (Trauma Research Center, Kashan University of Medical Sciences) ;
  • Moosavi, Golamabbas (Trauma Research Center, Kashan University of Medical Sciences) ;
  • Behdad, Samin (Trauma Research Center, Kashan University of Medical Sciences)
  • Received : 2011.12.21
  • Accepted : 2012.03.14
  • Published : 2012.04.01

Abstract

Background: Hemorrhoid is one of the most common surgical diseases occurring in the anorectal region. In this study, we evaluated the effect of ischiorectal fossa block on alleviating post hemorrhoidectomy pain. Methods: In this study, 90 patients suffering from hemorrhoids were evaluated. They were randomly divided into 3 groups. The first group had no block, the second group an ischiorectal block with placebo (normal saline), and the third group a preemptive ischiorectal block with bupivacaine. Postoperative variables such as pain intensity, pethidine consumption, nausea, and vomiting were compared between the groups. Results: The postoperative pain score in group 1 was $8.5{\pm}1.3$ and $8.1{\pm}0.9$ (P=NS) in group 2. The post operative analgesic demand was $3.1{\pm}1.5$ and $3.3{\pm}1.8$ hours in groups 1 and 2, respectively (P=NS). The post operative pain score and analgesic demand were $4.2{\pm}2.1$ and $9.3{\pm}2.7$ hours, respectively, in group 3 (P < 0.0001). Conclusions: Preemptive ischiorectal block reduces the posthemorrhoidectomy pain and opioid demand.

Keywords

References

  1. Mukhashavria GA, Qarabaki MA. Circumferential excisional hemorrhoidectomy for extensive acute thrombosis: a 14-year experience. Dis Colon Rectum 2011; 54: 1162-9. https://doi.org/10.1097/DCR.0b013e318221ea50
  2. Greco DP, Miotti G, Della Volpe A, Magistro C, De Carli S, Pugliese R. Stapled hemorrhoidopexy: day surgery or one day surgery? Surg Oncol 2007; 16 Suppl 1: S173-5.
  3. Liu ST, Wu CT, Yeh CC, Ho ST, Wong CS, Jao SW, et al. Premedication with dextromethorphan provides posthemorrhoidectomy pain relief. Dis Colon Rectum 2000; 43: 507-10. https://doi.org/10.1007/BF02237195
  4. Watt-Watson J, Chung F, Chan VW, McGillion M. Pain management following discharge after ambulatory same-day surgery. J Nurs Manag 2004; 12: 153-61. https://doi.org/10.1111/j.1365-2834.2004.00470.x
  5. Klein SM, Bergh A, Steele SM, Georgiade GS, Greengrass RA. Thoracic paravertebral block for breast surgery. Anesth Analg 2000; 90: 1402-5. https://doi.org/10.1097/00000539-200006000-00026
  6. Singelyn FJ, Aye F, Gouverneur JM. Continuous popliteal sciatic nerve block: an original technique to provide postoperative analgesia after foot surgery. Anesth Analg 1997; 84: 383-6. https://doi.org/10.1213/00000539-199702000-00027
  7. Kilbride M, Morse M, Senagore A. Transdermal fentanyl improves management of postoperative hemorrhoidectomy pain. Dis Colon Rectum 1994; 37: 1070-2. https://doi.org/10.1007/BF02049805
  8. Chester JF, Stanford BJ, Gazet JC. Analgesic benefit of locally injected bupivacaine after hemorrhoidectomy. Dis Colon Rectum 1990; 33: 487-9. https://doi.org/10.1007/BF02052143
  9. Brunicardi FC, Brandt ML, Andersen DK, Billiar TR, Dunn DL, Hunter JG, et al. Schwartz's principles of surgery. 9th ed. New York, McGraw-Hill. 2010, pp 342-58.
  10. Lally KP, Cox CS Jr, Andrassy RJ. History of appendicitis. In: Sabistone textbook of surgery: the biological basis of modern surgical practice. 16th ed. Edited by Townsend CM, Beauchamp RD, Evers ME, Mattox KL. Philadelphia, Saunders. 2001, p 919.
  11. Imbelloni LE, Vieira EM, Gouveia MA, Netinho JG, Spirandelli LD, Cordeiro JA. Pudendal block with bupivacaine for postoperative pain relief. Dis Colon Rectum 2007; 50: 1656-61. https://doi.org/10.1007/s10350-007-0216-7
  12. Naja Z, Ziade MF, Lönnqvist PA. Nerve stimulator guided pudendal nerve block decreases posthemorrhoidectomy pain. Can J Anaesth 2005; 52: 62-8. https://doi.org/10.1007/BF03018582
  13. Naja Z, El-Rajab M, Al-Tannir M, Ziade F, Zbibo R, Oweidat M, et al. Nerve stimulator guided pudendal nerve block versus general anesthesia for hemorrhoidectomy. Can J Anaesth 2006; 53: 579-85. https://doi.org/10.1007/BF03021848
  14. Crile GW. Phylogenetic association in relation to certain medical problems. Boston Med Surg J 1910; 163: 893-904. https://doi.org/10.1056/NEJM191012151632401
  15. Kehlet H. The modifying effect of anesthetic technique on the metabolic and endocrine responses to anesthesia and surgery. Acta Anaesthesiol Belg 1988; 39: 143-6.
  16. Rodrigues MR, Paes FC, Duarte LT, Nunes LG, Costa VV, Saraiva RA. Postoperative analgesia for the surgical correction of congenital clubfoot: comparison between peripheral nerve block and caudal epidural block. Rev Bras Anestesiol 2009; 59: 684-93. https://doi.org/10.1016/S0034-7094(09)70093-5

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  2. Comparison of Two Methods: Spinal Anesthesia and Ischiorectal Block on Post Hemorrhoidectomy Pain and Hospital Stay: A Randomized Control Trial pp.1521-0553, 2018, https://doi.org/10.1080/08941939.2017.1349221
  3. Could Frequent and Lengthy Masturbation Sessions Dispose to Hemorrhoids? vol.1, pp.3, 2012, https://doi.org/10.5812/thrita.7005
  4. Efficacy of metronidazole versus placebo in pain control after hemorrhoidectomy. Results of a controlled clinical trial vol.107, pp.None, 2012, https://doi.org/10.17235/reed.2015.3926/2015
  5. Evidence-Based Management of Pain After Excisional Haemorrhoidectomy Surgery: A PROSPECT Review Update vol.41, pp.2, 2012, https://doi.org/10.1007/s00268-016-3737-1
  6. Evidence-based review of methods used to reduce pain after excisional hemorrhoidectomy vol.39, pp.1, 2019, https://doi.org/10.1016/j.jcol.2018.10.007
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