Abstract
Background
This prospective randomized trial was used to compare two different local anesthetic techniques, local perianal anesthesia and pudendal nerve block, used for harmonic scalpel hemorrhoidectomy (HSH).
Methods
A total of 120 patients with grade III or IV hemorrhoids were randomly chosen to perform HSH (60 patients under local anesthesia—Group A and 60 patients under pudendal nerve block—Group B).
Results
Additional perioperative analgesia during the procedure was needed in 37 patients of group A and 18 patients of group B (P < 0.001). A total of 27 patients from group A and 8 patients from group B (P < 0.001) required additional postoperative analgesia apart from the standard administered analgesics. A statistical significant difference in favor of the second group (B)—(P < 0.003) was found regarding the discharge point from the hospital when the number of patients that were able to be discharged from the hospital on the day of the operation and the first postoperative day was the comparison parameter. Group B (P < 0.001) was superior to local group regarding VAS pain score at discharge for the patient group that were discharge on the day of surgery (5.1 vs. 2.2).
Conclusion
These data suggest that HSH performed under pudendal nerve block is a safe and efficient technique.
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References
Nyström PO, Derwinger K, Gerjy R (2004) Local perianal block for anal surgery. Tech Coloproctol 8(1):23–26
Fleischer M, Marini CP, Statman R, Capella J, Shevde K (1994) Local anesthesia is superior to spinal anesthesia for anorectal surgical procedures. Am Surg 60(11):812–815
Li S, Coloma M, White PF et al (2000) Comparison of the costs and recovery profiles of three anesthetic techniques for ambulatory anorectal surgery. Anesthesiology 93(5):1225–1230
Haveran LA, Sturrock PR, Sun MY et al (2007) Simple harmonic scalpel hemorrhoidectomy utilizing local anesthesia combined with intravenous sedation: a safe and rapid alternative to conventional hemorrhoidectomy. Int J Colorectal Dis 22(7):801–816
Zacharakis E, Kanellos D, Pramateftakis MG, Kanellos I, Angelopoulos S, Mantzoros I, Betsis D (2007) Long-term results after stapled haemorrhoidopexy for fourth-degree haemorrhoids: a prospective study with median follow-up of 6 years. Tech Coloproctol 11:144–147
Kanellos I, Zacharakis E, Kanellos D, Pramateftakis MG, Tsachalis T, Betsis D (2006) Long-term results after stapled haemorrhoidopexy for third-degree haemorrhoids. Tech Coloproctol 10:47–49
Kanellos I, Angelopoulos S, Zacharakis E, Kanellos D, Pramateftakis MG, Blouhos K, Betsis D (2005) Stapled haemorrhoidopexy for haemorrhoids in combination with lateral internal sphincterotomy for fissure-in-ano. Eur Surg Res 37:317–320
Κanellos I, Zacharakis E, Christoforidis E, Angelopoulos S, Kanellos D, Pramateftakis MG, Betsis D (2005) Usefulness of lateral internal sphincterotomy in reducing postoperative pain after open hemorrhoidectomy. World J Surg 29(4):464–468
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The authors declare that they have no conflict of interest related to the publication of this article.
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Tepetes, K., Symeonidis, D., Christodoulidis, G. et al. Pudendal nerve block versus local anesthesia for harmonic scalpel hemorrhoidectomy: a prospective randomized study. Tech Coloproctol 14 (Suppl 1), 1–3 (2010). https://doi.org/10.1007/s10151-010-0614-z
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DOI: https://doi.org/10.1007/s10151-010-0614-z