PDF(Pubmed)
Abstract：
BACKGROUND: Saddle block anesthesia (SBA) is a frequently preferred method for ambulatory anorectal surgery. This study aimed to observe the effects of two different dose SBAs on discharge times and perioperative block characteristics in patients undergoing ambulatory anorectal surgery.
METHODS: The study was conducted as a prospective, randomized controlled study. Patients over the age of 18 who were scheduled for ambulatory anorectal surgery and had American Society of Anaesthesiologists (ASA) physical status I and II were included in the research. Patients were divided into two groups: 5 mg hyperbaric bupivacaine 0.5% (Group I; n=34) and 3 mg hyperbaric bupivacaine 0.5% (Group II; n=34). The primary outcome was discharge time. Characteristics of the spinal block like time to reach S4 blockade, maximum blocked dermatome, regression time of sensorial, first analgesic need time, voiding time, mobilization time, and side effects were the secondary outcomes.
RESULTS: Sixty-eight patients were included in the study. The groups were similar in terms of demographic and surgical characteristics (p > 0.05). In Group II, S4 sensory dermatome blockade time was statistically longer (p: 0.007) and the time to the disappearance of the sensory block was statistically shorter (p < 0.001). Also, voiding time and discharge times were statistically shorter in Group II (p: 0.049, p < 0.001, respectively).
CONCLUSIONS: SBA provided adequate anesthesia, and the complication rates were limited. Saddle block can be considered an advantageous technique because of conditions that adversely affect recoveries, such as postoperative cognitive problems, nausea, and vomiting due to general anesthesia. In addition, better recovery results and optimal surgical condition with 3 mg hyperbaric bupivacaine in our study suggest that this dose may be a good alternative.
METHODS: The study was conducted as a prospective, randomized controlled study. Patients over the age of 18 who were scheduled for ambulatory anorectal surgery and had American Society of Anaesthesiologists (ASA) physical status I and II were included in the research. Patients were divided into two groups: 5 mg hyperbaric bupivacaine 0.5% (Group I; n=34) and 3 mg hyperbaric bupivacaine 0.5% (Group II; n=34). The primary outcome was discharge time. Characteristics of the spinal block like time to reach S4 blockade, maximum blocked dermatome, regression time of sensorial, first analgesic need time, voiding time, mobilization time, and side effects were the secondary outcomes.
RESULTS: Sixty-eight patients were included in the study. The groups were similar in terms of demographic and surgical characteristics (p > 0.05). In Group II, S4 sensory dermatome blockade time was statistically longer (p: 0.007) and the time to the disappearance of the sensory block was statistically shorter (p < 0.001). Also, voiding time and discharge times were statistically shorter in Group II (p: 0.049, p < 0.001, respectively).
CONCLUSIONS: SBA provided adequate anesthesia, and the complication rates were limited. Saddle block can be considered an advantageous technique because of conditions that adversely affect recoveries, such as postoperative cognitive problems, nausea, and vomiting due to general anesthesia. In addition, better recovery results and optimal surgical condition with 3 mg hyperbaric bupivacaine in our study suggest that this dose may be a good alternative.
摘要：
背景：鞍区阻滞麻醉（SBA）通常是门诊肛肠手术的首选方法。本研究旨在观察两种不同剂量的SBA对门诊肛肠手术患者出院时间和围手术期阻滞特征的影响。
方法：这项研究是前瞻性的，随机对照研究。这项研究包括了18岁以上的患者，他们计划进行门诊肛肠手术，并具有美国麻醉医师协会（ASA）的身体状况I和II。患者分为两组：5mg0.5％的高压布比卡因（I组；n=34）和3mg0.5％的高压布比卡因（II组；n=34）。主要结果是出院时间。脊柱阻滞的特征，如达到S4阻滞的时间，最大阻塞皮刀,感觉的回归时间，第一次镇痛需要时间，作废时间,动员时间,副作用是次要结局.
结果：68例患者被纳入研究。两组在人口统计学和手术特征方面相似(p>0.05)。在第二组中，S4感觉皮刀阻滞时间在统计学上更长（p：0.007），感觉阻滞消失的时间在统计学上更短（p<0.001）。此外，II组的排尿时间和出院时间在统计学上较短（分别为p：0.049，p<0.001）。
结论：SBA提供了足够的麻醉，并发症发生率有限。鞍块可以被认为是一种有利的技术，因为条件会对回收产生不利影响，比如术后认知问题，恶心,和全身麻醉引起的呕吐。此外,在我们的研究中，使用3mg高压布比卡因的更好的恢复结果和最佳的手术条件表明，该剂量可能是一个很好的选择。
方法：这项研究是前瞻性的，随机对照研究。这项研究包括了18岁以上的患者，他们计划进行门诊肛肠手术，并具有美国麻醉医师协会（ASA）的身体状况I和II。患者分为两组：5mg0.5％的高压布比卡因（I组；n=34）和3mg0.5％的高压布比卡因（II组；n=34）。主要结果是出院时间。脊柱阻滞的特征，如达到S4阻滞的时间，最大阻塞皮刀,感觉的回归时间，第一次镇痛需要时间，作废时间,动员时间,副作用是次要结局.
结果：68例患者被纳入研究。两组在人口统计学和手术特征方面相似(p>0.05)。在第二组中，S4感觉皮刀阻滞时间在统计学上更长（p：0.007），感觉阻滞消失的时间在统计学上更短（p<0.001）。此外，II组的排尿时间和出院时间在统计学上较短（分别为p：0.049，p<0.001）。
结论：SBA提供了足够的麻醉，并发症发生率有限。鞍块可以被认为是一种有利的技术，因为条件会对回收产生不利影响，比如术后认知问题，恶心,和全身麻醉引起的呕吐。此外,在我们的研究中，使用3mg高压布比卡因的更好的恢复结果和最佳的手术条件表明，该剂量可能是一个很好的选择。
