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首页> 外文期刊>Sao Paulo Medical Journal >Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy
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Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy

机译：局部渗透与脊柱阻滞在痔疮切除术中镇痛作用的随机临床研究

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BACKGROUND AND OBJECTIVES: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING: Randomized, prospective and comparative study at Dr. M??rio Gatti Hospital. METHODS: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included. The local group (LG) received local infiltration (0.75% ropivacaine) under general anesthesia; the spinal group (SG) received subarachnoid block (2 ml of 0.5% bupivacaine). Analgesic supplementation consisted of fentanyl for LG and lidocaine for SG. Postoperative pain intensity, sphincter relaxation, lower-limb strength, time to discharge, analgesic dose over one week and adverse effects were assessed. RESULTS: Eleven LG patients (52.4%) required supplementation, but no SG patients. Pain intensity was higher for LG up to 120 min, but there were no differences at 150 or 180 min. There were no differences in the need for paracetamol or tramadol. Times to first analgesic supplementation and hospital discharge were longer for SG. The adverse effects were nausea, dizziness and urinary retention. CONCLUSIONS: Pain intensity was higher in LG than in SG over the first 2 h, but without differences after 150 and 180 min. Time to first supplementation was shorter in LG. There were no differences in doses of paracetamol and tramadol, or in adverse effects. REGISTRATION: ClinicalTrials.gov NCT02839538.
机译：背景与目的：术后镇痛和早期康复对于出院很重要。这项研究的主要目的是比较肛周浸润和蛛网膜下腔麻醉对痔切除术的镇痛效果。次要目标是比较出院时间，不良反应和并发症。设计与地点：M ?? rio Gatti博士医院的随机，前瞻性和比较研究。方法：纳入美国麻醉医师协会1级或2级身体状况的40位18-60岁患者。局部麻醉（LG）在全身麻醉下接受局部浸润（0.75％罗哌卡因）;脊髓组（SG）接受蛛网膜下腔阻滞（2 ml 0.5％布比卡因）。止痛药的补充剂包括LG的芬太尼和SG的利多卡因。评估术后疼痛强度，括约肌松弛，下肢力量，出院时间，超过一周的止痛剂量以及不良反应。结果：11名LG患者（52.4％）需要补充，但无SG患者。 LG在120分钟以内的疼痛强度较高，但在150或180分钟时无差异。对乙酰氨基酚或曲马多的需求无差异。 SG首次使用止痛药和出院的时间更长。不良反应是恶心，头晕和尿retention留。结论：在最初的2小时内，LG的疼痛强度高于SG，但在150和180分钟后无差异。在LG中，首次补充的时间较短。扑热息痛和曲马多的剂量或不良反应无差异。注册：ClinicalTrials.gov NCT02839538。

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