Saddle block with a low dose of bupivacaine and pethidine for ambulatory hemorrhoidectomy

Abstract

Purpose: To evaluate the advantages of low dose pethidine or bupivacaine saddle block spinal anaesthesia (SA) for ambulatory hemorrhoidectomy.

Methods: In a prospective study, 30 ASA I-II patients randomly received SA with either 5 mg of 5% heavy bupivacaine (Group B), or 0.4 mg/kg 5% hyperbaric pethidine (Group P). The quality of anaesthesia, local (anal) motor block, postoperative pain and analgesics consumption, the time to micturition, ambulation at 12 and 24 h (PADS score) were assessed.

Results: No significant differences were recorded among the two groups regarding the quality of anaesthesia and local motor block. Pain score was significant better at 2 h for the patients who received bupivacaine (p=0.015) and at 8 h for the patients who received petidine (p=0.03). The consumption of postoperative analgetics did not differ among the two groups. Three patients from each group (20%) were not suitable for discharge at 24 h, pain, nausea and vomiting being the main reasons.

Conclusion: Saddle block spinal anaesthesia with either heavy bupivacaine or hyperbaric pethidine may be appropriate for ambulatory hemorrhoidectomy. The main advantage of spinal saddle block was a limited sensitive and local (anal) motor block.

Key words: pethidine, bupivacaine, anaesthetic saddle block, ambulatory anaesthesia, hemorrhoidectomy

Jurnalul Român de Anestezie Terapie intensivă 2003 Vol.10 Nr.2, 108-114

Anestezia subarahnoidiană „în şa” cu doze mici de petidină şi bupivacaină pentru hemoroidectomie în ambulator