DOI: 10.25881/BPNMSC.2019.26.31.010


Shikhmetov A.N.1, Vandanov B.K.2, Lebedev N.N.1, Zadikyan A.M.2

1 Institute for advanced training of physicians FGBI «NMSC named N. I. Pirogov» Ministry of Health of Russi, Moscow

2 MCHU Branch clinical and diagnostic center of PJSC Gazprom, Moscow


Presents the results of anesthesia in patients with stage 2–3 chronic hemorrhoids, who underwent departuredate hemorrhoids on an outpatient basis.

Materials and methods. All patients were divided into three study groups depending on the chosen method of anesthesia. In the first group, spinal anesthesia was performed. Patients of the second group underwent selective spinal anesthesia (saddle block), and patients of the third group – combined anesthesia: selective spinal anesthesia (saddle block) with prolonged epidural postoperative analgesia.

Results and discussion. The comparison of clinically significant indicators of spinal anesthesia. According to the time of onset of the sensory block, duration of anesthesia, the length of the latent period, the number of blocked segments, the depth of the motor block on the Bromage scale, at the beginning of activation of patients, the effectiveness of anesthesia after surgery. The introduction of low-volume doses of hyperbaric solution Of marcain hevy reduces the number of blocked segments without causing blockade of motor efferent innervation of the lower extremities. Almost no effect on indices of systemic arterial pressure, non-bradiaritmii. The use of extended epidural postoperative analgesia with a solution naropin, effectively relieves the pain and allows you to completely abandon narcotic analgesics.

Conclusion. This study confirmed that selective spinal anesthesia (saddle block) is an effective method of intraoperative analgesia in patients with chronic hemorrhoids and is most justified in an outpatient setting.

Keywords: ambulatory anesthesia; spinal anesthesia; selective spinal anaesthesia; epidural analgesia; chronic hemorrhoids; departuredate hemorrhoids.


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For citation

Shikhmetov A.N., Vandanov B.K., Lebedev N.N., Zadikyan A.M. Anesthesiological support of surgical intervention for chronic pain in outpatient. Bulletin of Pirogov National Medical & Surgical Center. 2019;14(2):45-48. (In Russ.)