Ultrasound Guided Caudal Block for Benign Anal Surgery

Universidad de Antioquia23 enrolled

Overview

Interventional study that evaluate analgesia and side effects of Ultrasound guided Caudal block preoperatively in benign canal anal surgery

Postoperative pain is an important symptom in patients after benign anal canal surgery. Caudal block has been described to decrease postoperative pain in this type of surgery. Ultrasound is a tool that facilitates its performance and increases the rate of a successful block. Objective: To determine the usefulness of ultrasound guided caudal block in anesthesia and postoperative analgesia in patients scheduled for benign anal surgery. Methods : Interventional study in adult patients that received ultrasound caudal anesthetic block before benign anal surgery. The investigators evaluated analgesic efficacy of this intervention by mean of numeric rating scale ( NRS) for pain after 6, 12 and 24 hours of surgery, rescue analgesia, motor block, urinary retention, surgical conditions and patient satisfaction in postoperative period.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Anal Fissure Anal Fistula Hemorrhoids Pain, Postoperative

Interventions

Ultrasound Guided Caudal BlockPROCEDURE

Using an external ultrasound probe, the investigators guided a 18 gauge epidural needle into the caudal space and injected a local anesthetic solution consisting in bupivacaine 0.25%, lidocaine 1% and dexamethasone 8mg in the caudal space.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age from 18 to 70 year old patient * schedule for benign anal surgery ( hemorrhoids, anal fistula, fissure or abcess ) * Caudal analgesic injection before surgery * Use of ultrasound to guide needle insertion into caudal space Exclusion Criteria: * cognitive impairment * verbal communication impairment * infection in skin at injection site * coagulopathy * technique refusal

Locations (1)

hospital universitario San Vicente Fundacion

Medellín, Antioquia, Colombia

Outcomes

Primary Outcomes

postoperative pain intensity (P3). Self reported pain intensity at 6, 12 and 24 hours after surgery.

The pain numeric Rating Scale (NRS) is a single 11-point numeric scale in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of their pain , with 0 representing one pain extreme (e.g., "no pain") and 10 representing the other pain extreme (e.g., "pain as bad as you can imagine" and "worst pain imaginable")

Time frame: 1 day

Secondary Outcomes

Rescue Analgesia (R3) need of opioid medication for rescue severe postoperative pain at 6, 12 and 24 hours after surgery.

Doses of intravenous tramadol for rescue in severe postoperative pain

Time frame: 1 day

Data from ClinicalTrials.gov

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