대한대장항문학회

Urinary retention in common benign anal surgery is a burden to ambulatory surgery. Purpose: To reduce voiding complication pudendal nerve block (PB) was applied in hemorrhoids surgery. Methods: We compared PB with spinal anesthesia (SA) for anal<br>surgery. In this prospective study, 163 patients undergoing elective hemorrhoids surgery by single surgeon were randomized to receive either PB with 0.5% bupivacaine (n=81) with 1：20,000 epinephrine or SA with 0.5% bupivacaine (n=83).<br>Results: There were no statistically significant differences in patient demographics, total amount of administered fluid, time to onset of block, or intraoperative pain. All patients had a successful block for surgery however, puborectalis muscle<br>relaxation with PB was not complete. The time from injection of the anesthetics to first development of pain was longer in the patients who received PB (9.1 vs 3.1h; P＜0.001). Urinary catheterization needed in only 6 patients in PB group<br>compared<br>with<br>57 cases in SA group (p＜0.001). Degree of pain was significantly low in PB (2.7 vs 5.2 with VAS; p＜0.001) Injected analgesics was significantly reduced in PB (16/81 vs 45/82; p＜0.001) Conclusions: Our results suggest that PB with bupivacaine<br>results<br>in fewer postoperative voiding complications and less pain compared with traditional SA in hemorrhoidectomy.<br>