Document Detail


Manometric study of the anal sphincter during haemorrhoidectomy using posterior perineal block.
MedLine Citation:
PMID:  16060189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Minor anorectal diseases affect 4-5% of the adult western population. Operations are performed on an ambulatory or 24-hour-stay basis. The aim of our study was to assess the physiology of anal sphincter relaxation by anal manometry after posterior perineal block during haemorrhoidectomy. We recruited 15 patients with third and fourth degree hemorrhoids in a manometric study of the anal sphincter during haemorrhoidectomy with regional anaesthesia. The patients underwent anal manometry before and 15 minutes after the posterior perineal block to determine the resting and squeeze anal pressures. Differences were considered significant at p < 0.05. We observed mean reductions of 34.6% and 37.1% in resting and squeeze pressure values, respectively, after posterior perineal block (p < 0.005). Our manometric study demonstrated that anal sphincter relaxation after posterior perineal block correlates with a significant reduction in resting and squeeze pressures because the block anaesthesia not only the somatic, but also the sympathetic fibres. We believe that posterior perineal block allows the surgeon to perform radical haemorrhoidectomy in the overnight stay setting with optimal intra- and postoperative analgesia, safe sphincter relaxation, lower postoperative complications, and lower costs to the public health service.
Authors:
Francesco Gabrielli; Matilde De Simone; Marco Chiarelli; Angelo Guttadauro; Marco Pagani; Marco Venturi; Luca Poggi; Michele M Ciulla; Ugo Cioffi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chirurgia italiana     Volume:  57     ISSN:  0009-4773     ISO Abbreviation:  Chir Ital     Publication Date:    2005 Jul-Aug
Date Detail:
Created Date:  2005-08-02     Completed Date:  2005-09-08     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151753     Medline TA:  Chir Ital     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  495-8     Citation Subset:  IM    
Affiliation:
University of Milano, Bicocca, Department of Surgery, Istituti Clinici Zucchi, Monza.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anal Canal / physiopathology*,  surgery
Anesthesia, Local
Evaluation Studies as Topic
Female
Hemorrhoids / physiopathology,  surgery*
Humans
Male
Manometry*
Middle Aged
Nerve Block*
Perineum*
Pressure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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