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*ANAL INTERSPHINCTERIC NERVE BLOCK PRIOR TO RUBBER BAND LIGATION OF HAEMORRHOIDS. IS IT EFFECTIVE? A RANDOMISED CONTROL TRIAL
Author(s) -
Collins S. J.,
Von Papen M.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04915_14.x
Subject(s) - medicine , analgesic , anesthesia , hemorrhoids , surgery , nerve block , randomized controlled trial
Purpose: Significant pain and discomfort are reported by a proportion of patients undergoing rubber band ligation of haemorrhoids. Several nerve blocks have been trialled with varied results. The aim of this study was to determine whether an anal intersphincteric nerve block may reduce post‐operative pain and analgesic requirements in these patients. Methodology: One hundred sequential patients undergoing rubber band ligation of haemorrhoids were randomised to either an anal intersphincteric nerve block using 0.5% Marcaine with adrenaline or to the control group. The procedures were performed by a single surgeon using the KilRoid (TM) rubber band ligator (Astratech – Sweden). Patients were assessed for pain and analgesic use in the immediate post operative period and at 24 hours. Both the patient and data collector were blinded to whether a nerve block had been administered. Results: There was no statistically significant difference between the two groups in median post operative pain (3.0 vs. 2.0 p > 0.0.29), median post operative analgesic use (1.6 vs. 3.3 p = 0.62), median pain score at 24 hour (4.14 vs. 4.22 p = 0.9) and median analgesic use at 24 hours (1.0 vs. 1.0 p = 0.13). Conclusions: There is no benefit from performing an intersphincteric nerve block in patients undergoing rubber band ligation of haemorrhoids.