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PTU-275 Facilitating early discharge with post-operative pudendal nerve block analgesia following ano-rectal procedures
  1. K Siddique1,
  2. K khan2,
  3. T Offori3
  1. 1General Surgery, Mid Yorkshire Hospitals NHS Trust, Dewsbury
  2. 2General Surgery, Barnsley Hospital Trust, Rotherham
  3. 3General Surgery, Barnsley Hospital Trust, Barnsley, UK

Abstract

Introduction Background: Effective postoperative pain control following benign ano-rectal procedures is an essential component of good clinical practice and early discharge. Aim of our study was to assess if early facilitated discharge can be achieved by this technique following ano-rectal procedures.

Method Patients and methods: A prospective study was conducted at Barnsley Hospital from Jan 14–Aug 14. All patients who underwent post-operative standard pudendal nerve block were included. Post-op stay was divided into three groups; group 1 = <4 h, group 2 = 4–6 h and group 3 = more than 6 h. Demographics, procedure performed, post-operative pain score, complications and readmissions were recorded and analysed.

Results Total number of patients was 36. There were 19 (54%) males while rest were female with an age of *36 (22–76) (* represents median). Procedures performed included laying open of fistula (12), complex fistula (2), Open haemorrhoidectomy (3), insertion of seton (1), excision of skin tag (2), fistulectomy (1) and lateral internal sphincterotomy (1) etc. There were no peri-operative complications. Pain scores reported as mild (27), moderate (7) and severe (2). The number of patients in group1, 2 and 3 were 14 (39%), 16 (44%) and 4 (115) respectively. Two patients stayed overnight due to social reasons. 32 (90%) patient agreed that pain relief worked and only 12 (33%) required additional pain relief. Two patients were re-admitted and 33 (92%) patients were very satisfied with this technique.

Conclusion Discussion and conclusions: Pudendal nerve block is a simple and useful method; without any significant complications, which can provide effective post-operative analgesia following ano-rectal procedures. It is associated with a high patient satisfaction and helped early facilitated discharges. Larger studies can help to look into efficacy and cost effectiveness.

Disclosure of interest None Declared.

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