Postoperative Outcome Comparison Between Pudendal Nerve Block and Caudal Block After Lateral Open Internal...

Area of Science:

• Anesthesiology
• Colorectal Surgery

Background:

• Chronic anal fissure treatment often involves open lateral internal sphincterotomy.
• Effective postoperative pain management is crucial for patient recovery after this procedure.

Purpose of the Study:

• To compare the postoperative outcomes of pudendal nerve block versus caudal block in patients undergoing open lateral internal sphincterotomy for chronic anal fissure.

Main Methods:

• A prospective, randomized, double-blind study included 123 patients undergoing elective open lateral internal sphincterotomy.
• Patients were divided into two groups: pudendal nerve block with local infiltration (Group I) and caudal block (Group II).
• Outcomes assessed included postoperative pain, surgical duration, hospital stay, and return to work.

Main Results:

• Postoperative outcomes were slightly enhanced in the caudal block group (Group II) compared to the pudendal nerve block group (Group I), though not statistically significant.
• Patients in Group I experienced moderate pain for a mean of 5.3 days versus 4.3 days in Group II.
• Return to normal activity was slightly faster in Group II (mean 7.5 days) compared to Group I (mean 8.0 days).

Conclusions:

• Pudendal nerve block is an excellent, easy, and safe alternative anesthesia for open lateral internal sphincterotomy.
• While caudal block may offer marginal benefits, pudendal nerve block provides a viable anesthetic option for this surgical procedure.