Ultrasound Guided Caudal Block for Benign Anal Surgery

Study Overview
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Brief Summary
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Interventional study that evaluate analgesia and side effects of Ultrasound guided Caudal block preoperatively in benign canal anal surgery

Detailed Description
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Postoperative pain is an important symptom in patients after benign anal canal surgery. Caudal block has been described to decrease postoperative pain in this type of surgery. Ultrasound is a tool that facilitates its performance and increases the rate of a successful block. Objective: To determine the usefulness of ultrasound guided caudal block in anesthesia and postoperative analgesia in patients scheduled for benign anal surgery. Methods : Interventional study in adult patients that received ultrasound caudal anesthetic block before benign anal surgery. The investigators evaluated analgesic efficacy of this intervention by mean of numeric rating scale ( NRS) for pain after 6, 12 and 24 hours of surgery, rescue analgesia, motor block, urinary retention, surgical conditions and patient satisfaction in postoperative period.

Official Title
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Ultrasound Guided Analgesic Caudal Block in Anal Canal Surgery

Conditions
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Anal Fissure, Anal Fistula, Hemorrhoids, Pain, Postoperative

Intervention / Treatment
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* Procedure: Ultrasound Guided Caudal Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age from 18 to 70 year old patient schedule for benign anal surgery ( hemorrhoids, anal fistula, fissure or abcess ) Caudal analgesic injection before surgery Use of ultrasound to guide needle insertion into caudal space Exclusion Criteria: cognitive impairment verbal communication impairment infection in skin at injection site coagulopathy technique refusal

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: interventional
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ultrasound Guided Caudal Block<br>30 minutes before benign canal anal surgery, a 18 G tuohy needle guided with an ultrasound probe to visualize the caudal space, a solution of bupivacaine 0.25%, Lidocaine 1% and dexamethasone 8mg was injected and needle removed. | Procedure: Ultrasound Guided Caudal Block<br>* Using an external ultrasound probe, the investigators guided a 18 gauge epidural needle into the caudal space and injected a local anesthetic solution consisting in bupivacaine 0.25%, lidocaine 1% and dexamethasone 8mg in the caudal space.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative pain intensity (P3). Self reported pain intensity at 6, 12 and 24 hours after surgery. | The pain numeric Rating Scale (NRS) is a single 11-point numeric scale in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of their pain , with 0 representing one pain extreme (e.g., no pain) and 10 representing the other pain extreme (e.g., pain as bad as you can imagine and worst pain imaginable) | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rescue Analgesia (R3) need of opioid medication for rescue severe postoperative pain at 6, 12 and 24 hours after surgery. | Doses of intravenous tramadol for rescue in severe postoperative pain | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ultrasound guided caudal block, anal surgery