A Ropivacaine-Lidocaine Combination for Caudal Blockade in Haemorrhoidectomy

Ye, F; Yx, Feng; Lin, Jinxi

doi:10.1177/147323000703500304

Cited by 23 publications

(8 citation statements)

References 23 publications

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“…Spinal or caudal anaesthesia and pudendal (ischiorectal) nerve blocks may cause urinary retention46, 48, 82, with a reported incidence of between 10 and 17 per cent46, 48. In view of this potential problem, perianal block (combined with submucous infiltration) alone was evaluated against general anaesthesia with the same block (without caudal or epidural) in the present study; no patient developed urinary retention.…”

Section: Discussionmentioning

confidence: 92%

“…Haemorrhoidectomy involves surgery on the sensitive anoderm, which is rich in nerve endings. Over the years, several possible ways of reducing pain and discomfort after this day‐care operation have been proposed, including use of multimodal analgesia5, 14–31, reducing postoperative anal spasm32–34, restricting surgery to one haemorrhoid at a time35, avoiding a closed technique36, use of bulky adherent dressings37, rectal application of metronidazole38, pre‐emptive analgesia3, 17, 39–43, diathermy dissection44, 45, caudal block8, 46, preoperative lactulose47, pudendal40, 48 and perineal11, 41, 42, 49, 50 blocks, stapled anopexy1, 51–63, Doppler‐guided haemorrhoid artery ligation64–74 and detailed counselling with a line of communication to the hospital5. Some of these are of doubtful value on their own48, 75, 76.…”

Section: Discussionmentioning

confidence: 99%

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Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia

Kushwaha

Hutchings

Davies

et al. 2008

British Journal of Surgery

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Background:Day-care open haemorrhoidectomy under local anaesthesia (LH) may be the most costeffective approach to haemorrhoidectomy. This prospective randomized trial compared outcome after LH from patients' and clinical perspectives with that after day-care open haemorrhoidectomy under general anaesthesia (GH).Methods: Forty-one patients with third-degree haemorrhoids were randomized to LH (19) or GH (22). Patient demographics were comparable. A single haemorrhoid was excised in 15 patients, and two and three haemorrhoids in 13 each. Independent nurse-led assessment and clinical evaluation were carried out for 6 months. Outcome measures were mean and expected pain scores at 30, 60 and 90 min, then daily for 10 days, and satisfaction scores at 10 days, 6 weeks and 6 months. Secondary outcomes were journey time within the day-surgery unit and overall cost.Results: Pain was worse following LH than GH at 90 min after surgery (P = 0·028), but pain scores on reaching home were similar. Maximum pain was experienced on day 3 after LH and on day 6 after GH. From day 1 onwards, daily pain scores were lower in the LH group, and there was a significant difference on day 8 (mean (95 per cent confidence interval) 3·61 (2·74 to 4·48) for LH versus 5·29 (4·12 to 6·45) for GH; P = 0·027). Mean pain over 10 days, expectation and satisfaction scores were similar in the two groups. LH had a shorter journey time and was less expensive than GH.Conclusion: LH has similar tolerance and clinical outcome to GH, and is associated with a shorter journey time and lower cost. Registration number: NCT00503269 (http://www.clinicaltrials.gov).

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia

Kushwaha

Hutchings

Davies

et al. 2008

British Journal of Surgery

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“…Analgesia following uvulopalatopharyngoplasty (UPPP) is a difficult problem in patients with obstructive sleep apnoea syndrome. Opioid-based analgesic protocols are usually used for postoperative analgesia for other diseases, 1,2 but because opioids can easily lead to respiratory depression, their use can be life threatening in patients with obstructive sleep apnoea syndrome. 3,4 Therefore, it is necessary to find a safe postoperative analgesic method for these patients.…”

Section: Introductionmentioning

confidence: 99%

Application of parecoxib in post-uvulopalatopharyngoplasty analgesia

2013

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Objective: To investigate the postoperative analgesic effects of parecoxib for uvulopalatopharyngoplasty (UPPP). Methods: Patients with obstructive sleep apnoea syndrome who underwent UPPP were randomly divided into two groups. In group A, the incision-local block was performed with 5 ml of 0.5% ropivacaine injected subcutaneously before the end of surgery, then 20 ml of physiological saline was injected intravenously every 12 h for 2 days. In group B, in addition to the incision-local block, 40 mg parecoxib was injected intravenously 30 min before the end of UPPP and 40 mg parecoxib was injected intravenously every 12 h for 2 days. Postoperative pain was measured using a visual analogue scale (VAS). Adverse reactions were recorded. Results: A total of 40 patients were randomized (n ¼ 20 per group). Under resting conditions, the mean AE SD VAS pain scores were significantly higher in group A compared with group B at 24 h and 48 h after UPPP (24 h 4.0 AE 0.8 versus 2.6 AE 0.6; 48 h 3.8 AE 0.7 versus 2.4 AE 0.5; respectively). Under swallowing conditions, the mean AE SD VAS pain scores were significantly higher in group A compared with group B at 8 h, 24 h and 48 h after UPPP. Postoperative adverse reactions were similar in the two groups. Conclusion: Intravenous parecoxib combined with incision-local ropivacaine provided effective postoperative analgesia for patients with obstructive sleep apnoea syndrome, undergoing UPPP.

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“…Mixtures of some anesthetics with a shorter induction time (Lidocaine) and a longer acting agent (Ropivacaine) are frequently used in order to obtain a short installation time for the sensory as well as for the motor block [1], and also a longer postoperative analgesia and anesthesia [2].…”

Section: Discussionmentioning

confidence: 99%

Combination of Ropivacaine and Lidocaine for Long Lasting Locoregional Anesthesia

Lazăr

Janos

Copotoiu

et al. 2014

Acta Medica Marisiensis

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Objective: The aim of this study was to evaluate the clinical utility of Ropivacaine 0.5% and Lidocaine 0.5% anestethic combination in performing locoregional anesthesia, using either peripheral nerve stimulator or ultrasounds for brachial plexus block. Study design: A prospective randomized clinical study was performed at the County Emergency Clinical Hospital of Tîrgu Mureș, between January and May 2013 on patients undergoing elective or emergency surgical interventions on upper limbs with locoregional anesthesia. Brachial plexus block with axillary approach was performed in 65 patients using randomly the nerve stimulator or the ultrasound guided technique. The parameters recorded were the duration of the anesthetic technique, the installation time and the length of anesthesia. All anesthetic incidents during and after anesthesia were observed as well. The recorded data were analyzed and statistically processed. Results: We enrolled 40 (61.5%) patients for the nerve stimulation technique and 25 (38.5%) patients for ultrasound guidance. The quality of the block was acceptable, an inadequate anesthesia was reported in 9 patients (13.8%). The mean time of installation of anesthesia was 34.36 (± 11.56) minutes, time recorded from the initiation of the anesthetic technique until complete motor block. The mean duration of the motor block was 481.3 (± 128.6) minutes which represents over 8 hours. None of the patients required conversion of the anesthesia due to the extended period of the surgical intervention. One patient presented a mild allergic reaction to the anesthetic drugs. Conclusion: Combination of the ropivacaine and lidocaine can be safely used for locoregional anesthesia, especially in those cases where long surgical intervention time is anticipated or in order to achieve a better postoperative analgesia

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A Ropivacaine-Lidocaine Combination for Caudal Blockade in Haemorrhoidectomy

Cited by 23 publications

References 23 publications

Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia

Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia

Application of parecoxib in post-uvulopalatopharyngoplasty analgesia

Combination of Ropivacaine and Lidocaine for Long Lasting Locoregional Anesthesia

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