Inferior rectal nerve block as analgesic for haemorroid surgery

Abstract

Aim : Is to evaluate the effectiveness of Inferior Rectal Nerve block ( IRNB ) in hemorrhoid surgery for post operative ( post op ) pain in the first 24 hours.Aim:The aim is to evaluate the effectiveness of IRNB as analgesic in haemorrhoid surgery in the first 24 hours post op.Methods:Efficacy of IRNB for hemorrhoid surgeries was prospectively evaluated on 200 consecutive patients over 14 months. Patients were divided into 2 groups. 100 patients received LA ( Twenty ml of local anesthetic ( 10 ml 0.25% bupivacaine and 10 ml 1% lignocaine with adrenaline was infiltrated into the anal sphincter under GA ( Group A ) , and 100 patients did not receive IRNB ( group B ). Rescue analgesia in the form of tramadol and diclofenac was available.Duration of analgesia; postoperative pain based on verbal response score (VAS 0-10); and complications were analyzed and recorded.Results:200 open haemorrhoidectomies were performed. Injection was done just after commencing GA , and 5 minutes onset time allowed before surgery started.Operative time ranged from 10-20 minutes .In Group B, tramadol and diclofenac were administered as rescue analgesia.Post op pain based on VAS was assessed during the next 24hours.Injection site hematoma (1%) was a reported complication in-group A.Conclusions:IRNB is effective, simple and effective analgesia in hemorrhoid surgery.