Authors
1
Specialist of Anesthesia and Intensive Care Unit in Maysan Maternity Hospital /Amarah, Maysan, Iraq
2
Cosultant Anesthetist in Renal Transplant Center in Ghazi al-Hariri surgical Specialist Hospital /Baghdad, Iraq
3
Specialist of Family Medicine in Urban Health Center /Baghdad, Iraq
4
Clinical Biochemistry /College of Science/ Al - Mustansiriyah University, Baghdad, Iraq
,
Document Type : Research Paper
Abstract
BACKGROUND:
Anorectal surgery includes pilonidal sinus, hemorrhoidectomy, anal fissure, and anal fistula operations. Various surgical and anesthetic techniques have been used to increase the level of patients perioperative analgesia and decrease the length of stay in the hospital.
AIM OF STUDY:
To compare the effectiveness of saddle block and caudal block during anorectal surgery on patients' perioperative hemodynamic values, onset of sensory and motor block, mobility and frequency of analgesia given post op.
PATIENTS AND METHODS:
80 patients underwent anorectal surgery were randomly allocated into 2 equallygroups, caudal block was applied to the 1st group 40pt. and saddle block was applied to the 2nd group 40 patients .Onset of Sensory and motor block was recorded. Heart rate, systolic arterial pressure, diastolic arterial pressure and oxygen saturation were measured every 3 minutes until the end of the operation. In postoperative period the frequency of rescue analgesic drugs given and duration of staying in hospital were recorded.
RESULTS:
In both groups, there were no changes in hemodynamic profile. No motor block was detected in group B but noted in group A. Onset of sensory nerve block in group B was more rapid than in group A and duration of post operative analgesia was shorter than that in group A. Early discharge from hospital was associated with group B in comparison with group A.
CONCLUSION:
Saddle block provides rapid-onset of sensory block, zero motor block, early ambulation and early hospital discharge in comparison to caudal block which was slower in onset with mild to moderate motor block and associated with increase time of staying in hospital.
- Gopal D V. Diseases of the rectum and anus: a clinical approach to common disorders. Clin Cornerstone. 2002;4:34–46.
- Garg H, Singh S, Bal K. Approach to the diagnosis of anorectal disorders. J IMSA. 2011;24:89–90.
- Gross JB. Women Experience More Pain and Require More Morphine Than Men to Achieve a Similar Degree of Analgesia. Surv Anesthesiol. 2004;48:209.
- Li S, Coloma M, White PF, Watcha MF, Chiu JW, Li H, et al. Comparison of the costs and recovery profiles of three anesthetic techniques for ambulatory anorectal surgery. Anesthesiol J Am Soc Anesthesiol. 2000;93:1225–30.
- Ternent CA, Fleming F, Welton ML, Buie WD, Steele S, Rafferty J. Clinical practice guideline for ambulatory anorectal surgery. Dis Colon Rectum. 2015;58:915–22.
- Boller AE. Does Oral Gabapentin Administered Prior to Scheduled Cesarean Delivery Decrease Pain With Movement in Adult Women at 24 Hours as Compared to Placebo? 2016;
- Imani F, Rahimzadeh P. Gabapentinoids: gabapentin and pregabalin for postoperative pain management. Anesthesiol pain Med. 2012;2:52.
- Sood RS, Sood A. Prevalence of myopia among the medical students in western India vis-à-vis the East Asian epidemic. IOSR J Dent Med Sci. 2014;13:65–67.
- Jaffar Al-sa’adi MH. Assessment of surgeon performed caudal block for anorectal surgery. Asian J Surg. 2019;42:240–43.
- Geze S, Imamoğlu M, Cekic B. Awake caudal anesthesia for inguinal hernia operations. Anaesthesist. 2011;60:841.
- Frawley G, Bell G, Disma N, Withington DE, De Graaff JC, Morton NS, et al. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia RepairData from the General Anesthesia Compared to Spinal Anesthesia Study—Comparing Apnea and Neurodevelopmental Outcomes. Anesthesiol J Am Soc Anesthesiol. 2015;123:55–65.
- Gross JB. Women Experience More Pain and Require More Morphine Than Men to Achieve a Similar Degree of Analgesia. Surv Anesthesiol. 2004;48:209.
- Neeta S, Sunil B V, Sonal Bhat SK, Madhusudan U. Saddle block spinal anesthesia and its effect on hemodynamic status and analgesia. Indian J Clin Anaesth. 2018;5:266–71.
- Li S, Coloma M, White PF, Watcha MF, Chiu JW, Li H, et al. Comparison of the costs and recovery profiles of three anesthetic techniques for ambulatory anorectal surgery. Anesthesiol J Am Soc Anesthesiol. 2000;93:1225–30.
- Bhattacharyya S, Bisai S, Biswas H, Tiwary MK, Mallik S, Saha SM. Regional anesthesia in transurethral resection of prostate (TURP) surgery: A comparative study between saddle block and subarachnoid block. Saudi J Anaesth. 2015;9:268.
- Shah AS, Choudhary ZA. Is caudal epidural anesthesia effective for anorectal surgery. Pak J Med Heal Sci. 2007;1:9–10. 7Ternent CA, Fleming F, Welton ML, Buie WD, Steele S, Rafferty J. Clinical practice guideline for ambulatory anorectal surgery. Dis Colon Rectum. 2015;58:915–22.
)
