The effect of ischioanal fossa block with bupivacain on decreasing post hemorrhoidectomy pain

Hemorrhoidectomy is usually associated with severe pain in the immediate postoperative period. Today, a number of local blockages and sedatives are used to reduce this pain. However, so far, no specific method is recommended for this purpose. Therefore, the aim of this study was to investigate the efficacy of the ischioanal fossa block, in reduction of postoperative pain and analgesic requirements. This clinical-trial study was performed on eighty candidates of elective hemorrhoidectomy. Patients were randomly assigned to either case (receiving ischioananl fossa block) or control (no ischioananl fossa block). All aspects of surgery and anesthesia were standardized. In the postoperative period, analgesia was maintained with pethedine. Pain was assessed using VAS (Visual analogue scale) at 0 (arousal), 4, 12 and, 24 hours after operations. The time interval for the first request of analgesia and the total amount of analgesic consumption were recorded. There was no statistical difference between the two groups with respect to age, sex, weight, and duration of operation. The pain score of the case and the control group was 2.65±0.92 and 4.93±1.09, respectively (p<0.05). Also, the pain score at 0, 4, 12, and 24 hrs post operation was significantly lower in the case than that in the control group (p<0.05). The time interval for request of the first analgesic was significantly longer in the case group (8 hr versus 1.5 hrs) (p<0.05). Total dose of pethedine consumption was statistically different between the two groups (p<0.05). Based on the results, the administration of ischiorectal fossa block and bupivacain before the operation resulted in a significant decrease in postoperative pain and analgesia requirements. Therefore, this method is recommended.