Local perianal block for anal surgery.

Area of Science:

• Anesthesiology
• Proctology
• Surgical Innovation

Background:

• A novel technique for local anesthesia targeting terminal nerve branches of the anus was developed.
• This method aims to improve pain management in proctological procedures.

Purpose of the Study:

• To evaluate the efficacy and safety of a refined local perianal block as the sole anesthetic method for various proctological operations.
• To assess postoperative pain levels and patient satisfaction with this anesthesia technique.

Main Methods:

• Thirty patients with proctological disorders underwent ambulatory or hospitalised surgery using the local perianal block.
• A 40 ml solution of ropivacaine was injected into the ischiorectal fat, targeting perianal terminal nerve branches.
• Postoperative pain was measured using a 0-10 visual analogue scale (VAS).

Main Results:

• Patients experienced pain-free anuses within 2-3 minutes of injection, enabling surgical exposure comparable to general anesthesia.
• Mean VAS scores at 24 hours varied by procedure: 3.2 for hemorrhoidectomy, 4.8 for stapled hemorrhoidopexy/skin tag excision, and 2.7 for fistula lay-open.
• At 1-2 weeks follow-up, patients reported high satisfaction and willingness to undergo the procedure again.

Conclusions:

• The perianal block is a simple and effective standalone anesthetic technique for proctological surgeries.
• This method offers a viable alternative to general anesthesia for specific anal procedures.
• High patient satisfaction suggests the technique is well-tolerated and effective.