Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802017000300247 |
Resumo: | ABSTRACT 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. Mário 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. |
id |
APM-1_10a224d9337c6bd93f46152d62c4a7db |
---|---|
oai_identifier_str |
oai:scielo:S1516-31802017000300247 |
network_acronym_str |
APM-1 |
network_name_str |
São Paulo medical journal (Online) |
repository_id_str |
|
spelling |
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomyAnesthesia, localAnesthesia, spinalAnalgesiaPostoperative complicationsHemorrhoidectomyRandomized controlled trialABSTRACT 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. Mário 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.Associação Paulista de Medicina - APM2017-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802017000300247Sao Paulo Medical Journal v.135 n.3 2017reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/1516-3180.2017.0001260117info:eu-repo/semantics/openAccessBorges,Luis Antônioda Cunha Leal,PlínioRey Moura,Ed CarlosSakata,Rioko Kimikoeng2017-07-20T00:00:00Zoai:scielo:S1516-31802017000300247Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2017-07-20T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy |
title |
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy |
spellingShingle |
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy Borges,Luis Antônio Anesthesia, local Anesthesia, spinal Analgesia Postoperative complications Hemorrhoidectomy Randomized controlled trial |
title_short |
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy |
title_full |
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy |
title_fullStr |
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy |
title_full_unstemmed |
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy |
title_sort |
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy |
author |
Borges,Luis Antônio |
author_facet |
Borges,Luis Antônio da Cunha Leal,Plínio Rey Moura,Ed Carlos Sakata,Rioko Kimiko |
author_role |
author |
author2 |
da Cunha Leal,Plínio Rey Moura,Ed Carlos Sakata,Rioko Kimiko |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Borges,Luis Antônio da Cunha Leal,Plínio Rey Moura,Ed Carlos Sakata,Rioko Kimiko |
dc.subject.por.fl_str_mv |
Anesthesia, local Anesthesia, spinal Analgesia Postoperative complications Hemorrhoidectomy Randomized controlled trial |
topic |
Anesthesia, local Anesthesia, spinal Analgesia Postoperative complications Hemorrhoidectomy Randomized controlled trial |
description |
ABSTRACT 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. Mário 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. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802017000300247 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802017000300247 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-3180.2017.0001260117 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.135 n.3 2017 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209265735696384 |