Pudendal nerve block in post- operative pain control in anal surgeries | ||||
| Benha Journal of Applied Sciences | ||||
| Article 6, Volume 7, Issue 3, March 2022, Page 39-44 PDF (843.15 K) | ||||
| Document Type: Original Research Papers | ||||
| DOI: 10.21608/bjas.2022.244807 | ||||
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| Authors | ||||
| Mosalam H.R.; Sopeh H.M.; Abd El Latif M.E.; Youssef R.R. | ||||
| General Surgery, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||||
| Abstract | ||||
| Foreground: Patients suffering from postoperative pain are more likely to need more time in ambulatory care units, which results in more unplanned admissions to hospitals. Treatment for pudendal neuralgia and elective anorectal operations such as fistula surgery and hemorrhoidectomy both benefit from the pudendal nerve block. This research compared the effectiveness of a pudendal nerve block for treating pain in individuals who had had anal operations to the effectiveness of more traditional analgesic techniques. Methods: A total of 100 patients were included in this research, all of them had anal surgery as follows: Patients in Group A received postoperative pudendal nerve blocks, which were administered to 50 patients in Group A. Five hundred patients in Group B are treated with postoperative regular analgesics. Results: The mean age in group A was 39.6 years, while the mean age in group B was 43.5 years. When it came to the participants' ages, there were no significant differences (P=0.193). In the first group, there were 26 men and 24 women; in the second, there were 26 men and 24 women (P = 1.0). Comparing groups A and B, group B (88.3 kg) had considerably more weight (81.2 kg). P-value was 0.035, although there were no significant differences in height (P-value = 0.403) or BMI (P-value = 0.110) between the two groups. Perianal fistulectomy was the most common operation in Group A, with 42.0% of patients undergoing it. Hemorrhoids were the second most common surgery, with 30% of patients undergoing it (18 percent ). Fissurectomy & sphincterotomy was the most common procedure in Group B (36.0%), followed by hemorrhoidectomy (34%) and Perianal fistulectomy (14 percent ). Group A had an average surgical time of 19.9 minutes, whereas group B had an average surgical time of 23 minutes. In terms of surgery time, there was no significant difference between the two groups (P-value was 0.148). In terms of VAS scores, group A's median VAS was considerably lower than group B's at 2, 6, 12, and 24 hours (P0.001) for all of them. Additional analgesia was required in only 32% of patients in group A, compared to 78% in group B; the P-value was 0.001. When it came to problems, there were four patients who had bleeding (4 patients), three who became infected (3 patients), and one who experienced incontinence (3 patients) (2 patients). There were 12 patients in Group B who had problems, with infection (4 patients), bleeding (3 patients), incontinence (2 patients), and urinary retention being the most common complications (2 patients). Complications occurred in both groups at the same rate (P=0.812). Neither the length of hospital stay (P=0.151) nor the return to regular activities (P=0.475) differed significantly between the two groups. In order to anticipate when analgesia might be required, researchers used a multivariate logistic regression model. Analgesic use was predicted by group B (odds ratio [OR] = 10.698, 95 percent confidence interval [CI] = 3.527-32.451; p-value=0.001) and surgery time (odds ratio [OR] = 1.172; 95 percent CI = 1.073–1.279; p-value=0.001). With the pudendal nerve block, pudendal neuralgia and elective anorectal treatments like fistula surgery and hemorrhoidectomy may be treated. Postoperative pain and the use of analgesics were both reduced when the pudendal nerve was blocked, but no differences were seen in terms of complications or duration of hospital stay. | ||||
| Keywords | ||||
| Pudendal nerve block; anal surgeries | ||||
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