Nerve block: perianal block: Difference between revisions
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* Perianal blocks have been shown to be comparable to general anesthesia for in terms of pain control in anal procedures including surgeries <ref>Gerjy, R. et al. Randomized clinical trial of stapled haemorrhoidopexy performed under local perianal block versus general anaesthesia. Br J Surgy. 2008; 95(11):1344-51.</ref> | <translate> | ||
* "Perianal block is a safe, feasible, reliable, and reproducible mode of anesthesia." <ref>Bharathi, R. et al. Evidence based switch to perianal block for ano-rectal surgeries. International Journal of Surgery. 2010; 8:29–31</ref> | |||
=Indications= | ==Overview== | ||
* [[Rectal foreign body|Rectal | |||
* [[External hemorrhoid excision]] | [[File:Gray542.png|thumb|Perineal innervation.]] | ||
* [[Rectal prolapse]] | *Perianal blocks have been shown to be comparable to general anesthesia for in terms of pain control in anal procedures including surgeries <ref>Gerjy, R. et al. Randomized clinical trial of stapled haemorrhoidopexy performed under local perianal block versus general anaesthesia. Br J Surgy. 2008; 95(11):1344-51.</ref> | ||
*[[Anorectal abscess]] | *"Perianal block is a safe, feasible, reliable, and reproducible mode of anesthesia." <ref>Bharathi, R. et al. Evidence based switch to perianal block for ano-rectal surgeries. International Journal of Surgery. 2010; 8:29–31</ref> | ||
=Contraindications= | |||
* Overlying | |||
* Allergy to | ==Indications== | ||
* Uncooperative | |||
= | *[[Special:MyLanguage/Rectal foreign body|Rectal foreign body]] removal | ||
* 20 cc Syringe with a 27 Gauge Needle | *[[Special:MyLanguage/External hemorrhoid excision|External hemorrhoid excision]] | ||
* Spare 18 Gauge Needle (to draw up anesthetic) | *[[Special:MyLanguage/Rectal prolapse|Rectal prolapse]] | ||
* Local Anesthetic (e.g. [[Lidocaine]] or [[Bupivacaine]]) | *[[Special:MyLanguage/Anorectal abscess|Anorectal abscess]] | ||
* Silk Tape | |||
* Pillow or Blankets | |||
* Packaged, Moist Towelette | ==Contraindications== | ||
= | |||
*Overlying infection | |||
* Obtain | *Allergy to chosen anesthetic | ||
* Place the patient in the prone position, placing either a pillow or blankets under their hips for comfort and ideal positioning | *Uncooperative patient | ||
* Using tape, separate the patient's buttocks from one another to better visualize the perianal area | |||
* Draw up anesthetic into | |||
* Ensure that the perianal area is clean by removing debris with | ==Equipment Needed== | ||
* Peripheral to the anal sphincter, choose multiple injection sites that allow for fanning circumferentially around the anus | |||
* Advance | *20 cc Syringe with a 27 Gauge Needle | ||
* Aspirate to rule out intravascular placement prior to injecting 3 -5 mL of anesthetic | *Spare 18 Gauge Needle (to draw up anesthetic) | ||
* Continue to the other preselected areas, fanning the needle circumferentially in order to surround the anal area with local anesthetic | *Local Anesthetic (e.g. [[Special:MyLanguage/Lidocaine|Lidocaine]] or [[Special:MyLanguage/Bupivacaine|Bupivacaine]]) | ||
=References= | *Silk Tape | ||
*Pillow or Blankets | |||
*Packaged, Moist Towelette | |||
==Procedure<ref>Nystrom, PO. et al. Local perianal block for anal surgery. Tech Coloproctol. 2004; 8(1):23-6</ref>== | |||
*Obtain informed consent | |||
*Place the patient in the prone position, placing either a pillow or blankets under their hips for comfort and ideal positioning | |||
*Using tape, separate the patient's buttocks from one another to better visualize the perianal area | |||
*Draw up anesthetic into 20 cc syringe using 18 Gauge Needle | |||
*Ensure that the perianal area is clean by removing debris with moist towelette | |||
*Peripheral to the anal sphincter, choose multiple injection sites that allow for fanning circumferentially around the anus | |||
*Advance 27 Gauge needle into one of these preselected areas | |||
*Aspirate to rule out intravascular placement prior to injecting 3 -5 mL of anesthetic | |||
*Continue to the other preselected areas, fanning the needle circumferentially in order to surround the anal area with local anesthetic | |||
==Complications== | |||
==See Also== | |||
*[[Special:MyLanguage/Nerve and regional blocks (main)|Nerve and regional blocks (main)]] | |||
==External Links== | |||
==References== | |||
<References/> | <References/> | ||
[[Category:Procedures]] | |||
[[Category:GI]] | |||
</translate> | |||
Latest revision as of 23:48, 4 January 2026
Overview
- Perianal blocks have been shown to be comparable to general anesthesia for in terms of pain control in anal procedures including surgeries [1]
- "Perianal block is a safe, feasible, reliable, and reproducible mode of anesthesia." [2]
Indications
Contraindications
- Overlying infection
- Allergy to chosen anesthetic
- Uncooperative patient
Equipment Needed
- 20 cc Syringe with a 27 Gauge Needle
- Spare 18 Gauge Needle (to draw up anesthetic)
- Local Anesthetic (e.g. Lidocaine or Bupivacaine)
- Silk Tape
- Pillow or Blankets
- Packaged, Moist Towelette
Procedure[3]
- Obtain informed consent
- Place the patient in the prone position, placing either a pillow or blankets under their hips for comfort and ideal positioning
- Using tape, separate the patient's buttocks from one another to better visualize the perianal area
- Draw up anesthetic into 20 cc syringe using 18 Gauge Needle
- Ensure that the perianal area is clean by removing debris with moist towelette
- Peripheral to the anal sphincter, choose multiple injection sites that allow for fanning circumferentially around the anus
- Advance 27 Gauge needle into one of these preselected areas
- Aspirate to rule out intravascular placement prior to injecting 3 -5 mL of anesthetic
- Continue to the other preselected areas, fanning the needle circumferentially in order to surround the anal area with local anesthetic
Complications
See Also
External Links
References
- ↑ Gerjy, R. et al. Randomized clinical trial of stapled haemorrhoidopexy performed under local perianal block versus general anaesthesia. Br J Surgy. 2008; 95(11):1344-51.
- ↑ Bharathi, R. et al. Evidence based switch to perianal block for ano-rectal surgeries. International Journal of Surgery. 2010; 8:29–31
- ↑ Nystrom, PO. et al. Local perianal block for anal surgery. Tech Coloproctol. 2004; 8(1):23-6