PURPOSE This study evaluated the use of adding morphine to bupivacaine in spinal anesthesia for pain control in patients who underwent an open hemorrhoidectomy. METHODS Forty patients were prospectively selected for an open hemorrhoidectomy at the same institution and were randomized into two groups of 20 patients each: group 1 had a spinal with 7 mg of heavy bupivacaine associated with 80 µg...

BACKGROUND AND OBJECTIVES Hemorrhoidectomy may be performed under several anesthetic techniques and in outpatient regimen. Postoperative pain is severe and may delay discharge. This study aimed at evaluating bilateral pundendal nerves block for post- hemorrhoidectomy analgesia. METHODS Bilateral pundendal nerves block with 0.25% S75:R25 bupivacaine was performed with nerve stimulator in 35 pa...

BACKGROUND The procedure for prolapse and haemorrhoids (PPH) was introduced to address the postoperative pain following excisional haemorrhoidectomy (EH). OBJECTIVE To assess the efficacy of both procedures to treat haemorrhoids. DATA SOURCES Literature review using MEDLINE. Articles addressing PPH and ER were included. STUDY SELECTION RCTs comparing PH and PPH with > or = 20 patients. ...

In the morning a healthy 40 years old female had a successful spinal anesthetic with bupivacaine 1% 10 mg for hemorrhoidectomy followed by a second injection at midnight for severe pain. The second traumatic injection caused a conus medullaris/cauda equina lesion discovered by MRI 45 days later. The contribution of hyperbaric bupivacaine dosage and pencil point needle is discussed.