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Minerva Surgery 2021 Aug 02

DOI: 10.23736/S2724-5691.21.08810-9


language: English

Pudendal nerve block (PNB): a safe, simple and effective approach in surgical proctological patients

Luca BONATTI 1, Stefania SONCINI 1, Alex B. BELLOCCHIA1, Dmitri SELIVANOV 2, Luca CESTINO 1, Federico FESTA 1 , Fabrizio. NATTA 1, Francesco QUAGLINO 1

1 General Surgery Division, Maria Vittoria Hospital, Turin, Italy; 2 Anesthesiology and Reanimation Division, Maria Vittoria Hospital, Turin, Italy


BACKGROUND: Pudendal nerve block (PNB) is commonly used in pudendal neuralgia (PN) and as an anaesthesiological technique in obstetrical and urological procedures. The purpose of this retrospective study was to compare the efficacy of PNB with other anaesthesiolocal techniques in proctological surgery.
METHODS: A total of 362 patients were seen from a 22 months time interval. Surgical indication was placed after a conservative therapy. 78 patients underwent surgery: 42 with spinal anaesthesia with PNB and 36 with PNB alone according to their anatomical characteristics. All the patients underwent PNB in lithotomy position and with a perirectal approach. The success rate of PNB was evaluated in post operative pain control with the VAS score, after the first and the second evacuation. The follow up also included a third check on the seventh day after surgery.
RESULTS: In post operative period, the mean VAS score found after the first evacuation in patients undergoing PNB was 2.66, after the second evacuation was 1.55, while the VAS score on the seventh day was 0.38. The mean VAS score in the group who underwent spinal anaesthesia and PNB were respectively 3.71 and 1.80 after the first and second evacuation. The VAS score calculated on the seventh day was 0.50. There were no statistically significant differences in the VAS score between the 2 groups (P >0.05).
CONCLUSIONS: PNB may be a valid alternative to spinal anaesthesia in proctological patients. PNB has proven to be both safe and effective technique.

KEY WORDS: Pudendal nerve block; Proctological; Excisional haemorroidectomy; Anal fistula; Anal anaesthesia

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