Postoperative Outcome Comparison Between Pudendal Nerve Block and Caudal Block After Lateral Open Internal Sphincterotomy.
OBJECTIVE
To assess the postoperative outcome between pudendal nerve block and caudal block after open lateral internal sphincterotomy for chronic anal fissure.


METHODS
Our prospective, randomized and double blind investigation included 123 patients, of both sexes, aged 25-56 years, classed I-II by the American society of anesthesiologists and scheduled for elective open internal lateral sphincterotomy for anal fissure at King Hussein hospital, KHMC, Amman, Jordan, during the period from Jan. 2013 to Feb. 2015. Patients were divided into two groups. Group I included 62 patients (GI, n=62) operated under pudendal nerve block with local infiltration anesthesia and group II included 61 patients (GII, n=61) operated under caudal block. Postoperative pain, surgical duration, period of hospital admission, back to regular working activity and 4 weeks evaluation were compared between the two groups.


RESULTS
Postoperative outcome was more enhanced in group II but not significant than in group I. Patients in G-I experienced moderate pain for a mean of 5. 3 days in comparison with 4. 3 days in G-II. P>0. 05. Three patients (4. 9%) in G-II in comparison with 5 patients (8. 1%) in G-I had more hospital stay than 24 hours. Patients in G-II went back to normal activity after a mean of 7. 5 days in comparison with 8. 0 days in G-I.


CONCLUSIONS
Undergoing open lateral internal sphincterotomy with the aid of Pudendal nerve block is an excellent, easy and safe alternative anesthesia to caudal anesthesia.
Department of anesthesia, KHMC, Jordan.
Hazem Mohammad
HM
Alkhaldi
Department of general surgery, KHMC, Jordan.
Wasfi Mohammad
WM
Salaita
Department of anesthesia, KHMC, Jordan.
Mohammad Ahmad
MA
Shabaneh
Department of general surgery, KHMC, Jordan.
Mohammad Ibrahim
MI
Al-Horut
Department of general surgery, KHMC, Jordan.
Raed Mohameh Abu Azzam
RM
Aldabbas
Department of general surgery, KHMC, Jordan.
Ahmad Ali
AA
Uraiqat
D000328:Adult; D000763:Anesthesia, Caudal / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005401:Fissure in Ano / Q000601:surgery; D006801:Humans; D000074722:Lateral Internal Sphincterotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D061646:Operative Time; D010149:Postoperative Pain / Q000453:epidemiology; D060525:Pudendal Nerve; D062707:Return to Work / Q000706:statistics & numerical data
block; caudal; outcome; postoperative; pudendal; sphincterotomy