INTRODUCTION: Recently, some authors have reported that the pudendal nerve block using ropivacaine provides good postoperative analgesia. Thus, we consider of interest to compare two anesthetic methods checking postoperative analgesia and adverse effects. OBJECTIVE: To compare two anesthetic techniques (spinal anesthesia with morphine versus spinal anesthesia without morphine associated with pudendal nerve block) for hemorrhoidectomy in relation to postoperative analgesia and adverse effects. MATERIALS AND METHODS: We studied 40 patients from Hospital Regional de Mato Grosso do Sul among March to October of 2008. All patients were randomized by lot immediately before surgery, distributed in two groups: Group 1: 20 patients undergoing spinal anesthesia with morphine 0.15µg associated with hyperbaric bupivacaine 10mg; - Group 2: 20 patients undergoing spinal anesthesia with heavy bupivacaine 10mg associated with bilateral pudendal nerve block with ropivacaine 10mg/ml diluted in 10ml of distilled water. RESULTS: Most patients were female (N = 21). The average age was 52 years, ranging from 21 to 72 years. The group 1 presented a higher prevalence of adverse effects (62.5%). Among the adverse effects of group 1 was higher prevalence of itch, urinary retention and migraine. Most patients who reported pain in the postoperative range from group 1 was male and prevailing in the first 12 hours, with the average level of pain of 1.55. In group 2 the pain was observed in equal proportion in both sexes and in the first six hours, with the average level of pain of 1.75. CONCLUSION: The hemorrhoidectomy accomplished with spinal anesthesia without morphine and blockade of the pudendal nerve using ropivacaine provided better analgesic effect in the period of 12 hours after the surgery and it didn't present complications in this casuistry, being shown superior to the spinal anesthesia with morphine.
Hemorrhoids; surgery; spinal anesthesia; complications
