Nerve block: perianal block: Difference between revisions
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= | ==Overview== | ||
* 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> | * 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> | ||
* "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> | * "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= | |||
==Indications== | |||
* [[Rectal foreign body|Rectal Foreign Body Removal]] | * [[Rectal foreign body|Rectal Foreign Body Removal]] | ||
* [[External hemorrhoid excision]] | * [[External hemorrhoid excision]] | ||
* [[Rectal prolapse]] | * [[Rectal prolapse]] | ||
*[[Anorectal abscess]] | *[[Anorectal abscess]] | ||
=Contraindications= | |||
==Contraindications== | |||
* Overlying Infection | * Overlying Infection | ||
* Allergy to Chosen Anesthetic | * Allergy to Chosen Anesthetic | ||
* Uncooperative Patient | * Uncooperative Patient | ||
= | |||
==Equipment Needed== | |||
* 20 cc Syringe with a 27 Gauge Needle | * 20 cc Syringe with a 27 Gauge Needle | ||
* Spare 18 Gauge Needle (to draw up anesthetic) | * Spare 18 Gauge Needle (to draw up anesthetic) | ||
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* Pillow or Blankets | * Pillow or Blankets | ||
* Packaged, Moist Towelette | * Packaged, Moist Towelette | ||
= | |||
==Procedure<ref>Nystrom, PO. et al. Local perianal block for anal surgery. Tech Coloproctol. 2004; 8(1):23-6</ref>== | |||
* Inform the patient about the procedure and potential complications | * Inform the patient about the procedure and potential complications | ||
* Obtain Consent to perform the procedure | * Obtain Consent to perform the procedure | ||
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* Aspirate to rule out intravascular placement prior to injecting 3 -5 mL of anesthetic | * 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 | * Continue to the other preselected areas, fanning the needle circumferentially in order to surround the anal area with local anesthetic | ||
=References= | |||
==Complications== | |||
==See Also== | |||
==External Links== | |||
==References== | |||
<References/> | <References/> | ||
[[Category:Procedures]] | |||
Revision as of 05:12, 6 February 2017
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]
- Inform the patient about the procedure and potential complications
- Obtain Consent to perform the procedure
- 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 your 20 cc syringe using the spare 18 Gauge Needle
- Ensure that the perianal area is clean by removing debris with the Moist Towelette
- Peripheral to the anal sphincter, choose multiple injection sites that allow for fanning circumferentially around the anus
- Advance the syringe with the 27 Gauge needle attached 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