RT Journal Article
SR Electronic
T1 Posterior Perineal Block with Ropivacaine 0.75% for Pain Control During and After Hemorrhoidectomy
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 228
OP 232
DO 10.1053/rapm.2003.50132
VO 28
IS 3
A1 Georges Brunat
A1 Yvan Pouzeratte
A1 Claude Mann
A1 Jean-Michel Didelot
A1 Jean-Claude Rochon
A1 Jean-Jacques Eledjam
YR 2003
UL http://rapm.bmj.com/content/28/3/228.abstract
AB Background and Objectives As perioperative pain management is a difficult challenge during hemorrhoidectomy, we tested the hypothesis that posterior perineal block (PPB) with local anesthetics alone is able to provide adequate pain control during and after surgery.Methods In a prospective, blinded, randomized study, we studied analgesic conditions and side effects of PPB in American Society of Anesthesiologists (ASA) I-II patients undergoing hemorrhoidectomy. Patients received general anesthesia (GA) either with PPB (0.75% ropivacaine, 40 mL (PPB group) or without PPB (control group). All patients received intravenous morphine patient-controlled analgesia (PCA) for postoperative pain control (morphine, 1.5 mg-boluses, 8-minute lockout interval). Intra- and postoperative opioids consumption was recorded, and pain assessments were performed at 1, 2, 4, 8, 12, and 24 hours using a visual analog scale (VAS).Results VAS scores were significantly lower during the first 8 postoperative hours in the PPB group as compared with the control group (P < .001). The PPB group required significantly less opioids during anesthesia (P < .001) and during the first postoperative day (P < .001) as compared with the control group. Time to first defecation and duration of hospitalization were identical in both groups.Conclusions The present study shows that PPB with 40 mL 0.75% ropivacaine (300 mg) was a simple, effective, and safe method to provide better postoperative analgesia than PCA alone following surgical hemorrhoidectomy. In addition, PPB was shown to significantly reduce opioid consumption intraoperatively and during the first postoperative day.