KẾT QUẢ VÀ TÁC DỤNG KHÔNG MONG MUỐN CỦA PHƯƠNG PHÁP GIẢM ĐAU BẰNG GÂY TÊ MẶT PHẲNG CƠ DỰNG SỐNG ĐOẠN CÙNG Ở BỆNH NHÂN SAU MỔ CẮT TRĨ LONGO NĂM 2024

Abstract

Background: Hemorrhoidectomy is a cause of moderate to severe postoperative pain. Commonly used analgesics after hemorrhoidectomy (systemic, spinal, epidural) are often inadequate in providing pain relief and have many adverse effects. Sacral spinal plane block (ESP) is a newly introduced technique that has shown promise in various surgical procedures. Objective: A clinical trial describing a series of cases aimed to evaluate the analgesic effect of sacral ESP and adverse effects after Longo hemorrhoidectomy. Subjects and Methods: Thirty patients underwent spinal anesthesia for Longo hemorrhoidectomy. Postoperatively, ESP anesthesia was performed under ultrasound guidance and multimodal analgesia. Visual analog scale (VAS) pain score at rest and at 24 hours of activity was used as the primary outcome measure. Secondary outcome measures were cumulative fentanyl dose, number of patients requiring postoperative rescue analgesia, and QoR-15 quality of recovery. In addition, adverse events were compared between the two groups: nausea and vomiting, urinary retention, and itching. Results: The mean VAS scores of the ESP group at all time points in the first 24 hours were always lower than 4. Few patients in the control group required emergency analgesia. Fentanyl dosage in the first 24 hours after surgery was low in the ESP group. Furthermore, QoR-15 in the ESP group was high. Conclusion: ESP anesthesia is also an effective method for pain control after Longo hemorrhoidectomy, reducing opioid requirements and improving patient recovery.