Perineal Nerve block for Anterio-posterior Repair of the vagina

Abstract

Aim : Is to evaluate the effectiveness  and practicability of  Perineal Nerve Block (PNB )   in Anterior-Posterior Repair (  AP ) repair of the vagina for post operative pain

This study was a comparative study  included 200 patients , divided into two groups . One received perineal nerve block  ( PNB ) , and the other group did not receive. Pain score was used in both groups. Pain was severe in the group that did not receive the nerve block , while the group received PNB did not show significant pain.

Methods

Efficacy of PNB  was prospectively evaluated on 200 consecutive patients over 24 months. 100 patients received LA ( Twenty ml of local anesthetic ( 10 ml 0.25% bupivacaine and  10 ml 1% lignocaine was infiltrated into both sides of the vaginal verge under General Anaesthesia ( GA )  to block the perineal nerve , and 100 patients did not receive PNB. Rescue analgesia in the form of tramadol and Intravenous ( I V ) paracetamol was available.

Duration of analgesia ; post operative pain based on (VAS 0-10); and complications were analyzed.

Results: 200 AP repair surgeries were performed. Injection was done just after commencing GA , and 5 minutes onset time allowed before surgery started.

Operative time ranged from 25-30 minutes, and tramadol and paracetamol were administered  as rescue analgesia.

Post op pain based on  VAS  was assessed during the next 48 hours.

 Injection site hematoma (3%) was the complications observed.

Conclusions:

 PNB is effective , simple and reliable analgesia in AP repair of the vagina surgery