Department of Anesthesiology, The First People's Hospital of Foshan, Foshan, China.
Pain Res Manag. 2021 Feb 26;2021:6644262. doi: 10.1155/2021/6644262. eCollection 2021.
Several anesthesia techniques were applied to hemorrhoidectomy, but postoperative pain and urinary retention were still two unsolved problems. The aim of this prospective randomized study was to evaluate the effect of ultrasound-guided pudendal nerve block (PNB) combined with deep sedation compared to spinal anesthesia for hemorrhoidectomy. . One hundred and twenty patients undergoing Milligan-Morgan hemorrhoidectomy were randomized to receive PNB combined with deep sedation using propofol (Group PNB, = 60) or spinal anesthesia (Group SA, = 60). Pain intensity was assessed using the visual analogue scale (0: no pain to 10: worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on walking at 12, 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, and patient satisfaction after surgery. . Ultrasound-guided bilateral PNB combined with deep sedation using propofol could successfully be applied to Milligan-Morgan hemorrhoidectomy. Postoperative pain intensity was significantly lower in Group PNB compared to Group SA at rest at 3, 6, 12, 24, 36, and 48 h ( < 0.001) and during mobilization at 12, 24, 36, and 48 h ( < 0.001) postoperatively. Sufentanil consumption in Group PNB was significantly lower than that in Group SA, during 0-24 h ( < 0.001) and during 24-48 h ( < 0.001) postoperatively. Urinary retention was significantly lower in Group PNB compared to Group SA (6.9% vs 20%, =0.034). The patients in Group PNB had higher satisfaction compared to Group SA ( < 0.001). . Ultrasound-guided PNB combined with propofol sedation is an effective anesthesia technique for Milligan-Morgan hemorrhoidectomy.
几种麻醉技术被应用于痔切除术，但术后疼痛和尿潴留仍然是两个未解决的问题。本前瞻性随机研究的目的是评估超声引导阴部神经阻滞（PNB）联合深度镇静与脊髓麻醉在痔切除术的效果。120 例接受 Milligan-Morgan 痔切除术的患者被随机分为接受 PNB 联合丙泊酚深度镇静（PNB 组，n=60）或脊髓麻醉（SA 组，n=60）。疼痛强度采用视觉模拟评分法（0：无痛至 10：最痛）评估。主要结局是记录术后 3、6、12、24、36 和 48 小时静息时和术后 12、24、36 和 48 小时行走时的疼痛评分。次要结局是术后镇痛药物消耗、不良反应和患者满意度。超声引导双侧 PNB 联合丙泊酚深度镇静可成功应用于 Milligan-Morgan 痔切除术。与 SA 组相比，PNB 组术后静息时 3、6、12、24、36 和 48 小时（<0.001）和术后 12、24、36 和 48 小时（<0.001）疼痛强度明显降低，移动时疼痛强度明显降低。与 SA 组相比，PNB 组舒芬太尼消耗在 0-24 小时（<0.001）和 24-48 小时（<0.001）期间明显降低。与 SA 组相比，PNB 组尿潴留发生率明显降低（6.9% vs 20%，=0.034）。与 SA 组相比，PNB 组患者满意度更高（<0.001）。超声引导 PNB 联合丙泊酚镇静是一种有效的 Milligan-Morgan 痔切除术麻醉技术。
