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Effectiveness and safety of ultra-low-dose spinal anesthesia versus perineal blocks in hemorroidectomy and anal fistula surgery: a randomized controlled trial

BACKGROUND: Ultra-low-dose Spinal Anesthesia (SA) is the practice of employing minimal doses of intrathecal agents so that only the roots that supply a specific area are anesthetized. The aim of this study was to compare the effectiveness and safety of ultra-low-dose spinal anesthesia with that of P...

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Autores principales: Peterson Soares Santos, Rafael, Dias de Oliveira-Filho, Alfredo, de Freitas Lins Neto, Manoel Álvaro, Correia Lins, Lucas, Timbó Barbosa, Fabiano, Felizardo Neves, Sabrina Joany
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625141/
https://www.ncbi.nlm.nih.gov/pubmed/37247818
http://dx.doi.org/10.1016/j.bjane.2023.05.002
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author Peterson Soares Santos, Rafael
Dias de Oliveira-Filho, Alfredo
de Freitas Lins Neto, Manoel Álvaro
Correia Lins, Lucas
Timbó Barbosa, Fabiano
Felizardo Neves, Sabrina Joany
author_facet Peterson Soares Santos, Rafael
Dias de Oliveira-Filho, Alfredo
de Freitas Lins Neto, Manoel Álvaro
Correia Lins, Lucas
Timbó Barbosa, Fabiano
Felizardo Neves, Sabrina Joany
author_sort Peterson Soares Santos, Rafael
collection PubMed
description BACKGROUND: Ultra-low-dose Spinal Anesthesia (SA) is the practice of employing minimal doses of intrathecal agents so that only the roots that supply a specific area are anesthetized. The aim of this study was to compare the effectiveness and safety of ultra-low-dose spinal anesthesia with that of Perineal Blocks (PB). METHODS: A two-arm, parallel, double-blind randomized controlled trial comparing two anesthetic techniques (SA and PB) for hemorrhoidectomy and anal fistula surgery was performed. The primary outcomes were postoperative pain, complementation and/or conversion of anesthesia, and hemodynamic changes. RESULTS: Fifty-nine patients were included in the final analysis. The mean pain values were similar in the first 48 h in both groups (p > 0.05). The individuals allocated to the SA group did not need anesthetic complementation; however, those in the PB group required it considerably (SA group, 0% vs. PB group, 25%; p = 0.005). Hemodynamic changes were more pronounced after PB: during all surgical times, the PB group showed lower MAP values and higher HR values (p < 0.05). Postoperative urinary retention rates were similar between both groups (SA group 0% vs. PB group 3.1%, p = 0.354). CONCLUSION: SA and PB are similarly effective in pain control during the first 48 h after hemorrhoidectomy and anal fistula surgery. Although surgical time was shorter among patients in the PB group, the SA technique may be preferable as it avoids the need for additional anesthesia. Furthermore, the group that received perineal blocks was under sedation with a considerable dose of propofol.
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spelling pubmed-106251412023-11-05 Effectiveness and safety of ultra-low-dose spinal anesthesia versus perineal blocks in hemorroidectomy and anal fistula surgery: a randomized controlled trial Peterson Soares Santos, Rafael Dias de Oliveira-Filho, Alfredo de Freitas Lins Neto, Manoel Álvaro Correia Lins, Lucas Timbó Barbosa, Fabiano Felizardo Neves, Sabrina Joany Braz J Anesthesiol Original Investigation BACKGROUND: Ultra-low-dose Spinal Anesthesia (SA) is the practice of employing minimal doses of intrathecal agents so that only the roots that supply a specific area are anesthetized. The aim of this study was to compare the effectiveness and safety of ultra-low-dose spinal anesthesia with that of Perineal Blocks (PB). METHODS: A two-arm, parallel, double-blind randomized controlled trial comparing two anesthetic techniques (SA and PB) for hemorrhoidectomy and anal fistula surgery was performed. The primary outcomes were postoperative pain, complementation and/or conversion of anesthesia, and hemodynamic changes. RESULTS: Fifty-nine patients were included in the final analysis. The mean pain values were similar in the first 48 h in both groups (p > 0.05). The individuals allocated to the SA group did not need anesthetic complementation; however, those in the PB group required it considerably (SA group, 0% vs. PB group, 25%; p = 0.005). Hemodynamic changes were more pronounced after PB: during all surgical times, the PB group showed lower MAP values and higher HR values (p < 0.05). Postoperative urinary retention rates were similar between both groups (SA group 0% vs. PB group 3.1%, p = 0.354). CONCLUSION: SA and PB are similarly effective in pain control during the first 48 h after hemorrhoidectomy and anal fistula surgery. Although surgical time was shorter among patients in the PB group, the SA technique may be preferable as it avoids the need for additional anesthesia. Furthermore, the group that received perineal blocks was under sedation with a considerable dose of propofol. Elsevier 2023-05-27 /pmc/articles/PMC10625141/ /pubmed/37247818 http://dx.doi.org/10.1016/j.bjane.2023.05.002 Text en © 2023 Sociedade Brasileira de Anestesiologia. Published by Elsevier España, S.L.U. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Investigation
Peterson Soares Santos, Rafael
Dias de Oliveira-Filho, Alfredo
de Freitas Lins Neto, Manoel Álvaro
Correia Lins, Lucas
Timbó Barbosa, Fabiano
Felizardo Neves, Sabrina Joany
Effectiveness and safety of ultra-low-dose spinal anesthesia versus perineal blocks in hemorroidectomy and anal fistula surgery: a randomized controlled trial
title Effectiveness and safety of ultra-low-dose spinal anesthesia versus perineal blocks in hemorroidectomy and anal fistula surgery: a randomized controlled trial
title_full Effectiveness and safety of ultra-low-dose spinal anesthesia versus perineal blocks in hemorroidectomy and anal fistula surgery: a randomized controlled trial
title_fullStr Effectiveness and safety of ultra-low-dose spinal anesthesia versus perineal blocks in hemorroidectomy and anal fistula surgery: a randomized controlled trial
title_full_unstemmed Effectiveness and safety of ultra-low-dose spinal anesthesia versus perineal blocks in hemorroidectomy and anal fistula surgery: a randomized controlled trial
title_short Effectiveness and safety of ultra-low-dose spinal anesthesia versus perineal blocks in hemorroidectomy and anal fistula surgery: a randomized controlled trial
title_sort effectiveness and safety of ultra-low-dose spinal anesthesia versus perineal blocks in hemorroidectomy and anal fistula surgery: a randomized controlled trial
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625141/
https://www.ncbi.nlm.nih.gov/pubmed/37247818
http://dx.doi.org/10.1016/j.bjane.2023.05.002
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