J Korean Surg Soc.  2010 Feb;78(2):106-110. 10.4174/jkss.2010.78.2.106.

Local Perianal Block in Anal Surgery: The Disadvantage of Pain during Injection despite High Patient Satisfaction

• Park SJ
• Choi SI
• Lee SH
• Lee KY

• KMID: 2096563
• DOI: http://doi.org/10.4174/jkss.2010.78.2.106

Abstract

PURPOSE
We evaluated the usefulness of anal surgery using local perianal block and assessed patient satisfaction.
METHODS
From January to October 2008, a total of 41 consecutive patients consented to anal operation with local perianal block for stapled hemorrhoidopexy (n=15), excisional hemorrhoidectomy (n=9), fistulotomy (n=13), or abscess drainage (n=4). Postoperative pain was evaluated on a visual analogue scale (VAS) from 0 to 10. Patient satisfaction was evaluated through telephone interviews.
RESULTS
The mean peak VAS scores on the day of operation were 3.3 after stapled hemorrhoidopexy, 2.9 after excisional hemorrhoidectomy, 2.6 after fistulotomy, and 3.5 after abscess drainage; on postoperative day 1, the scores were 1.3, 1, 0.9, and 2.3, respectively. The majority of patients (31; 86.1%) were satisfied with the postoperative results (very satisfied 12, satisfied 19, only fair 5, unsatisfied 0). More than half of the patients (23; 63.9%) were satisfied with the use of local anesthesia (very satisfied 4, satisfied 19, only fair 12, unsatisfied 1). The mean VAS scores during injection were significantly different between the satisfied group (very satisfied and satisfied) and not-satisfied group (only fair and unsatisfied) treated with the local anesthesia (satisfied group: 3.5 and not-satisfied group: 5.4, P=0.04). Most patients (30; 83.3%) would undergo this anesthetic procedure again if future anal surgeries were necessary.
CONCLUSION
Local perianal block is feasible for various anal operations and results in a high degree of satisfaction among patients. However, the pain associated with injection has an adverse effect on patient satisfaction.

Keyword

Local anesthesia; Proctology; Injection; Pain; Satisfaction

MeSH Terms

Abscess
Anesthesia, Local
Colorectal Surgery
Drainage
Hemorrhoidectomy
Humans
Pain, Postoperative
Patient Satisfaction
Telephone

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