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Local perianal block for anal surgery
Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
2004 (English)In: Techniques in Coloproctology, ISSN 1123-6337, E-ISSN 1128-045X, Vol. 8, no 1, 23-26 p.Article in journal (Refereed) Published
Abstract [en]

Background: We refined a technique for local block of all terminal nerve branches to the anus. Methods: A total of 30 consecutive patients with proctological disorders consented to ambulatory (n=29) or hospitalised (n=1) operation with local perianal block for skin tags, Milligan-Morgan haemorrhoidectomy, stapled haemorrhoidopexy or anocutaneous fistulae. Patients were operated prone. A total of 40 ml of a 4.75 mg/ml solution of ropivacaine (Narop, Astra, Sweden) was injected in 8 directions (5 ml each) into the ischiorectal fat immediately peripheral to the external sphincter as anaesthetic columns reaching from the skin to the levator. This injection scheme targets the terminal nerve branches of the anus rather than blocking the trunk of major nerves. The relaxation of a pain-free anus was obtained in 2-3 minutes with exposure similar to a general anaesthetic. Postoperative pain was evaluated on a 0 to 10 visual analogue scale (VAS). Results: Patients were pain-free at discharge. However, mean postoperative VAS score at 24 hours was 3.2 following Milligan-Morgan haemorrhoidectomy, 4.8 following stapled haemorrhoidopexy and skin tags or polyps excision, and 2.7 after fistula lay-open. At telephone follow-up 1-2 weeks later, the patients were satisfied with the method of anaesthesia and would willingly accept it for any further anal surgery. Conclusions: The perianal block is easy to apply and effective as sole method of anaesthesia for proctological operations.

Place, publisher, year, edition, pages
2004. Vol. 8, no 1, 23-26 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-28276DOI: 10.1007/s10151-004-0046-8Local ID: 13383OAI: oai:DiVA.org:liu-28276DiVA: diva2:249080
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13

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Nyström, Per-OlofGerjy, Roger

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Faculty of Health SciencesDivision of surgeryDepartment of Surgery in Östergötland
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