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Evidence based switch to perianal block for ano-rectal surgeries
Ramanathan Saranga Bharathi1, Vinay Sharma, Ajay Kumar Dabas
160 Parachute Field Hospital, C/o 56 APO, 904060, India. sarangabharathi@rediffmail.com
International Journal of Surgery (London, England)
|October 6, 2009
Summary
Perianal block (PAB) is a safe and effective anesthesia for proctologic surgeries. This study shows PAB is feasible, with high success rates and minimal complications, making it a preferred choice.
Area of Science:
- Anesthesiology
- Colorectal Surgery
Background:
- Spinal/general anesthesia (SA/GA) may have disadvantages for proctologic surgeries.
- Perianal block (PAB) is proposed as a potentially advantageous alternative.
Purpose of the Study:
- To evaluate the feasibility and efficacy of perianal block (PAB) for proctologic surgeries.
- To assess the practicability of switching from SA/GA to PAB.
Main Methods:
- Prospective evaluation of PAB in 100 consecutive patients undergoing proctologic surgery.
- Administration of 30 ml local anesthetic (0.25% bupivacaine + 1% lignocaine with adrenaline) for PAB.
- Analysis of anesthesia onset, success rate, conversion to general anesthesia (GA), operative parameters, recovery, analgesia duration, pain scores (VRS), and complications.
Main Results:
- PAB was successful in 97% of cases, with a 3% conversion rate to GA.
- Average onset of anesthesia was 3 minutes; operative ease and relaxation were good.
- Median operative time was 20 minutes; analgesia lasted a median of 5 hours.
- Postoperative pain (VRS 10-40) and recovery were generally smooth with minor complications (1% hematoma, 1% reactionary bleeding).
Conclusions:
- Perianal block (PAB) is a safe, feasible, reliable, and reproducible anesthetic technique for ano-rectal surgeries.
- The demonstrated efficacy supports the adoption of PAB as the anesthesia of choice for these procedures.
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