anorectal surgery
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2022 ◽  
Vol 270 ◽  
pp. 421-429
Author(s):  
Sarah M. Kling ◽  
George A. Taylor ◽  
Matthew M. Philp ◽  
Juan Lucas Poggio ◽  
Howard M. Ross ◽  
...  

2021 ◽  
pp. 44-52
Author(s):  
T. N. Garmanova ◽  
D. R. Markaryan ◽  
E. A. Kazachenko ◽  
А. M. Lukianov ◽  
M. A. Agapov

Aim: To assess the efficiency of the micro-flavonoid fraction (MMF) administration prior to anorectal surgery with spinal anesthesia on postoperative pain severity reduction.Methods: Patients of our clinic who meet the following inclusion criteria are included: they must be diagnosed with surgical treatment of anorectal diseases. All participants are randomly divided into 2 groups: the first one gets a tablet with 1000 mg MFF (Detralex®), the second one gets a tablet containing starch per os 14 days before surgery (72 participants per arm). Then patients of each group will continue MFF administration for 30 days after surgery. Patients of both arms receive spinal anesthesia and undergo surgery. Following the procedure the primary and secondary outcomes are evaluated: frequency of the opioid drugs intake, the severity of the postoperative pain syndrome, duration and frequency of other drugs intake, readmission rate, overall quality of life, time from the procedure to returning to work and the complications rate, C-reactive protein level.Discussion: the MFF intake allows reducing the severity of the hemorrhoidal disease symptoms during conservative treatment. In addition, the Detralex® efficacy has been proven in postoperative pain reduction for patients diagnosed with varicose veins of the lower extremities. We intend to evaluate the feasibility of the preoperative MFF administration for the postoperative pain reduction and the decrease of the postoperative complications in patients with hemorrhoidal disease.


Surgery ◽  
2021 ◽  
Author(s):  
Kent J. Peterson ◽  
Paul Dyrud ◽  
Colin Johnson ◽  
Jacqueline J. Blank ◽  
Daniel C. Eastwood ◽  
...  

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alison R. Althans ◽  
Katherine Hrebinko ◽  
Oluwatosin Olaitan ◽  
Maria Ettore ◽  
Kellie Cunningham ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257283
Author(s):  
Xuehan Li ◽  
Jun Li ◽  
Pei Zhang ◽  
Huifei Deng ◽  
Mingan Yang ◽  
...  

Background Caudal epidural block (CEB) provides reliable anesthesia for adults undergoing anorectal surgery. Despite the widely utilization, the minimum effective concentration for 90% patients (MEC90) of ropivacaine for CEB remains unknown. Objective To estimate MEC of ropivacaine for CEB in anorectal surgery. Design A prospective dose-finding study using biased coin design up-and-down sequential method. Setting Operating room and postoperative recovery area of Chengdu Shangjin Nanfu Hospital, from October 2019 to January 2020. Patients 50 males and 51 females scheduled for anorectal surgery. Interventions We conducted two independent biased coin design up-and down trials by genders. The concentration of ropivacaine administered to the first patient of male and female were 0.25% with fixed volume of 14ml for male and 12ml for female patients based on our previous study. In case of failure, the concentration was increased by 0.05% in the next subject. Otherwise, the next subject was randomized to a concentration 0.05% less with a probability of 0.11, or the same concentration with a probability of 0.89. Success was defined as complete sensory blockade of perineal area 15 min after the block evidenced by the presence of a lax anal sphincter and pain-free surgery. Main outcome measures The MEC of ropivacaine to achieve a successful CEB in 90%(MEC90) of the patients. Results The MEC90 of ropivacaine for CEB were estimated to be 0.35% (95% CI 0.29 to 0.4%) for male and 0.353% (95%CI 0.22 to 0.4%) for female. By extrapolation to MEC in 99% of subjects (MEC99) and pooled adjacent violators algorithm (PAVA) adjusted responses, it would be optimal to choose 0.4% ropivacaine with a volume of 14ml for male and 12ml for female. Conclusions A concentration of 0.35% ropivacaine with a volume of 14ml provided a successful CEB in 90% of the male patients, while 0.353% ropivacaine with a volume of 12ml provided a successful CEB in 90% of the female patients. A concentration of 0.4% and a volume of 14ml for male and 12 ml for female would be successful in 99% of the patients. Trial registration Chictr.org.cn identifier: No. ChiCTR 1900024315.


2021 ◽  
Vol 8 ◽  
Author(s):  
Tomas Poskus ◽  
Matas Jakubauskas ◽  
Karolis Čekas ◽  
Lina Jakubauskiene ◽  
Kestutis Strupas ◽  
...  

Background: General or regional anesthesia is predominantly used for anorectal surgery, however in the recent years more attention was drawn in the use of local anesthesia for anorectal surgery. In this study we present the technique and results of the use of local perianal anesthetic infiltration for minor anorectal operations.Methods: In this cohort study patients undergoing surgery for hemorrhoids, anal fissures and low anal fistulas were included. Posterior perineal block was induced with a mixture containing 0.125% bupivacaine and 0.5% lidocaine. All patients were followed up at 30 days either by a post-operative visit or a telephone call and all post-operative complications over the post-operative 30-day period were registered.Results: One thousand and twenty-six consecutive patients were included in our study. For all patients' intraoperative analgesia was achieved after performing perianal anesthetic infiltration and no additional support from the anesthesia team was necessary in any of case. Complications were observed in 14 (1.4%). Urinary retention occurred in 5 (0.5%) cases. Six cases of bleeding occurred after hemorrhoidectomy (0.6%) and 1 (0.1%) after lateral internal sphincterotomy. Perianal abscess developed for two patients (0.2%).Conclusions: Local anesthesia using posterior perineal block technique is safe and effective for intraoperative analgesia in anorectal surgery, saving a substantial operation cost by avoiding the involvement of an anesthesia team and resulting in minimal incidence of urinary retention and other complications.


2021 ◽  
Vol 5 (4) ◽  
pp. 67-69
Author(s):  
Shubin Zhu ◽  
Qunhu Feng

Objective: To observe the effect of fuming-washing with traditional Chinese medicine (TCM) after anorectal surgery. Methods: 116 cases of patients with surgical operation were selected in the anorectal department of our hospital, which is Shenzhen Bao’an Hospital of Traditional Chinese Medicine, Shenzhen. According to the different postoperative adjuvant treatment methods implemented by patients, they were divided into two groups under the premise of equal number of patients. Among them, 58 cases of patients with traditional Chinese medicine (TCM) fuming-washing treatment were divided into study group, and patients with hip bath treatment with potassium permanganate solution were divided into common group. The efficacy of adjuvant therapy was observed. Results: The observation and analysis showed that the actual effect of TCM adjuvant therapy was more prominent, and the difference between groups was more significant (P < 0.05). Conclusion: The effect of traditional Chinese medicine adjuvant therapy is more significant than that of chemical method, which can help patients achieve better postoperative recovery effect. We should popularize this treatment in time for patients after surgery, and improve the prognosis of patients.


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