[show abstract][hide abstract] ABSTRACT: Based on our institution's initial results that reflected reduced postoperative pain using a modified pudendal nerve block technique, we conducted a prospective, randomized, double-blind study to investigate whether a combination of general anesthesia and bilateral nerve stimulator guided pudendal nerve blocks could provide better postoperative pain relief compared to general anesthesia alone or in combination with placebo nerve blocks.
Following Ethical Committee approval and informed consent 90 patients scheduled for hemorrhoidectomy were randomized to three different groups of 30 patients each: general anesthesia alone, general anesthesia plus nerve stimulator guided pudendal nerve block or general anesthesia plus placebo nerve blocks. Postoperative pain, the primary outcome variable of the study, was assessed by visual analogue scale scores at predetermined time intervals during the postoperative period. Total amount of analgesics, time to return to normal activities and patient satisfaction were also recorded.
The pudendal nerve block group was found to have better postoperative pain-relief (P < 0.005), reduced need for analgesics (P < 0.05), and also a more rapid return to normal activities (P < 0.001) compared to general anesthesia alone or in combination with placebo blocks. The pudendal nerve block group was also associated with significantly higher patient satisfaction (P < 0.001) compared to the other two groups.
A combination of general anesthesia and nerve stimulator guided pudendal nerve block showed significantly reduced postoperative pain, shortened hospital stay, and earlier return to normal activity. Thus, this technique deserves more widespread use in patients undergoing hemorrhoidectomy.
Canadian Journal of Anaesthesia 02/2005; 52(1):62-8. · 2.13 Impact Factor
[show abstract][hide abstract] ABSTRACT: Breast cancer surgery is frequently associated with postoperative nausea, vomiting, pain and painful restricted movement. It is well established that thoracic paravertebral block with or without general anesthesia provides better postoperative analgesia and reduces the risk of nausea and vomiting after breast surgery as well as the incidence of chronic pain. Paravertebral block improves the quality of recovery after breast cancer surgery and provides the patient with the option of ambulatory discharge.
Le Journal médical libanais. The Lebanese medical journal 57(2):110-4.