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Perianal block
From WikEM
Contents
Overview
- Perianal blocks have been shown to be comparable to general anesthesia for in terms of pain control in anal procedures including surgeries [1]
- "Perianal block is a safe, feasible, reliable, and reproducible mode of anesthesia." [2]
Indications
Contraindications
- Overlying infection
- Allergy to chosen anesthetic
- Uncooperative patient
Equipment Needed
- 20 cc Syringe with a 27 Gauge Needle
- Spare 18 Gauge Needle (to draw up anesthetic)
- Local Anesthetic (e.g. Lidocaine or Bupivacaine)
- Silk Tape
- Pillow or Blankets
- Packaged, Moist Towelette
Procedure[3]
- Obtain informed consent
- Place the patient in the prone position, placing either a pillow or blankets under their hips for comfort and ideal positioning
- Using tape, separate the patient's buttocks from one another to better visualize the perianal area
- Draw up anesthetic into 20 cc syringe using 18 Gauge Needle
- Ensure that the perianal area is clean by removing debris with moist towelette
- Peripheral to the anal sphincter, choose multiple injection sites that allow for fanning circumferentially around the anus
- Advance 27 Gauge needle into one of these preselected areas
- Aspirate to rule out intravascular placement prior to injecting 3 -5 mL of anesthetic
- Continue to the other preselected areas, fanning the needle circumferentially in order to surround the anal area with local anesthetic
Complications
See Also
External Links
References
- ↑ Gerjy, R. et al. Randomized clinical trial of stapled haemorrhoidopexy performed under local perianal block versus general anaesthesia. Br J Surgy. 2008; 95(11):1344-51.
- ↑ Bharathi, R. et al. Evidence based switch to perianal block for ano-rectal surgeries. International Journal of Surgery. 2010; 8:29–31
- ↑ Nystrom, PO. et al. Local perianal block for anal surgery. Tech Coloproctol. 2004; 8(1):23-6
