Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Sep 15;102(37):e35168.
doi: 10.1097/MD.0000000000035168.

Effect of sacral erector spinae plane block on post-hemorrhoidectomy pain: A randomized controlled trial

Affiliations
Randomized Controlled Trial

Effect of sacral erector spinae plane block on post-hemorrhoidectomy pain: A randomized controlled trial

Aydin Mermer et al. Medicine (Baltimore). .

Abstract

Background: Hemorrhoidectomy is a common surgical procedure associated with significant postoperative pain. The conventional analgesic methods used for hemorrhoidectomy often have adverse effects and may not provide adequate pain relief. The sacral erector spinae plane block (ESPB) is a newly introduced technique that has shown promise in various surgical procedures. This prospective, randomized, controlled trial aimed to evaluate the analgesic effects of sacral ESPB following hemorrhoidectomy.

Methods: Seventy patients undergoing hemorrhoidectomy were divided into 2 groups: the control group and the sacral ESPB group. Bilateral sacral ESPB was performed in the sacral ESPB group, whereas no intervention was performed in the control group. The numeric rating scale at rest and during the active period (mobilizing) was used as the primary outcome measure. Secondary outcome measures were the cumulative doses of tramadol, the number of patients who required rescue analgesia postoperatively, and quality of recovery-15 Turkish version patient recovery quality.

Results: The sacral ESPB group had significantly low numeric rating scale scores at various time points (P < .05). More patients in the control group needed rescue analgesia during the postoperative period (P < .001). The dosages of tramadol consumption after the first 24 hours postoperatively were significantly lower in the sacral ESPB group compared with the control group (P < .001). Furthermore, quality of recovery-15 Turkish version scores were high in the sacral ESPB group (P < .001).

Conclusion: The results suggest that sacral ESPB is an effective method for post-hemorrhoidectomy pain management, reducing the need for additional analgesics and improving patient recovery.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Summary of the distribution of NRS at different time intervals in both the resting and active periods (mobilizing). NRS = numeric rating scale.
Figure 2.
Figure 2.
Comparison of QoR-15T scores by group and summary of distribution (P < .001). QoR-15T = quality of recovery-15 Turkish version.

References

    1. Borges LA, da Cunha Leal P, Rey Moura EC, et al. . Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy. Sao Paulo Med J. 2017;135:247–52. - PMC - PubMed
    1. Nygren J, Thacker J, Carli F, et al. .; Enhanced Recovery After Surgery Society. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS®) society recommendations. Clin Nutr. 2012;31:801–16. - PubMed
    1. Ferrandis C, De Faucal D, Fabreguette J-M, et al. . Efficacy of Doppler-guided hemorrhoidal artery ligation with mucopexy, in the short and long terms for patients with hemorrhoidal disease. Tech Coloproctol. 2020;24:165–71. - PubMed
    1. Gerbershagen HJ, Aduckathil S, van Wijck AJ, et al. . Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118:934–44. - PubMed
    1. Medina-Gallardo A, Curbelo-Peña Y, De Castro X, et al. . Is the severe pain after Milligan-Morgan hemorrhoidectomy still currently remaining a major postoperative problem despite being one of the oldest surgical techniques described? A case series of 117 consecutive patients. Int J Surg Case Rep. 2017;30:73–5. - PMC - PubMed

Publication types

MeSH terms