Perianal blockage with 0.5% bupivacaine for postoperative pain relief in hemorrhoidectomy.

dc.contributor.authorJirasiritham, Siriwanen_US
dc.contributor.authorTantivitayatan, Kamthornen_US
dc.contributor.authorJirasiritham, Soponen_US
dc.date.accessioned2009-05-27T20:49:32Z
dc.date.available2009-05-27T20:49:32Z
dc.date.issued2004-06-29en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractHemorrhoidectomy can be done in many positions under many anesthetic techniques as an ambulatory surgery. Post-procedural pain is frequently severe enough to delay home discharge. A combination between preincisional local anesthetics and general anesthesia looks attractive in terms of preemptive analgesia and starting time of surgery. The study aimed to compare anesthetic time, pain-free period and pain relief in patients with and without 0.5% plain bupivacaine infiltration after mask inhalation, total intravenous anesthesia or endotracheal tube general anesthesia. MATERIAL AND METHOD: 142 patients were randomized into control (C) and study (S) groups with n = 70 and 72 respectively. Patient characteristics in both groups were: age 40.45 +/- 13.03 VS 37.48 +/- 13.63 years old, BW 59.77 +/- 11.19 VS 58.80 +/- 9.76 kg, male:female 31/39 VS 43/29, PS 1/2/3/E = 48/19/1/2 VS 53/15/3/1 for C and S respectively. All underwent surgery in lithotomy under ET/TIVA/mask: 53/13/4 VS 22/27/23 and anesthetic time was 49.02 +/- 18.04 VS 33.33 +/- 10.31 min (p < 0.05). RESULTS: Pain-free periods in C and S were 204.44 +/- 878.07 and 540 +/- 298.03 min with median times of 57.5 (n = 67) VS 560 (n = 58) min. Pain severity in S was mainly none or mild degree while in C it was moderate or severe, apparently when analysed in subgroups of ET and TIVA. Analgesic requirements were statistically more in group C. CONCLUSION: Better postoperative pain relief could be accomplished by preincisional 0.5% plain bupivacaine infiltration after general anesthesia. The technique helped relax anal muscles for surgical ease and avoided patient discomfort in case of a prolonged procedure. Preemptive analgesia and key pain management were discussed.en_US
dc.description.affiliationDepartment of Anesthesiology, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.en_US
dc.identifier.citationJirasiritham S, Tantivitayatan K, Jirasiritham S. Perianal blockage with 0.5% bupivacaine for postoperative pain relief in hemorrhoidectomy. Journal of the Medical Association of Thailand. 2004 Jun; 87(6): 660-4en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/43703
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAdulten_US
dc.subject.meshAnesthetics, Local --administration & dosageen_US
dc.subject.meshBupivacaine --administration & dosageen_US
dc.subject.meshDigestive System Surgical Proceduresen_US
dc.subject.meshFemaleen_US
dc.subject.meshHemorrhoids --surgeryen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPain, Postoperative --prevention & controlen_US
dc.subject.meshProspective Studiesen_US
dc.titlePerianal blockage with 0.5% bupivacaine for postoperative pain relief in hemorrhoidectomy.en_US
dc.typeClinical Trialen_US
dc.typeJournal Articleen_US
dc.typeRandomized Controlled Trialen_US
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