Ultrasound-guided Pudendal Nerve Block for Pain After Hemorrhoidectomy

Effects of Ultrasound-guided Pudendal Nerve Block on Postoperative Pain and Quality of Recovery in Patients Undergoing Hemorrhoidectomy

The goal of this clinical trial is to investigate the effects of ultrasound-guided pudendal nerve block on postoperative pain, opioid consumption, and quality of recovery in patients receiving Ferguson hemorrhoidectomy.

Patients who have symptomatic hemorrhoids undergoing Ferguson hemorrhoidectomy under spinal anesthesia will be randomized to receive bilateral ultrasound-guided pudendal nerve block with 0.5% ropivacaine or normal saline immediately after surgery. In addition, intravenous patient controlled analgesia, NSAIDs, and acetaminophen will be used in all participants for postoperative pain control. Postoperative pain on numerical rating scale (NRS), opioid consumption, quality of recovery (QOR-15), patient's satisfaction, and complications will be recorded at 6, 12, 24, 48 hours and 7 days after surgery.

Inclusion Criteria:

• Patients with symptomatic hemorrhoids (grade III and grade IV internal hemorrhoids, mixed hemorrhoids, and external hemorrhoids)
• Age 20 to 65 years old
• American Society of Anesthesiologists (ASA) classification I~III
• Receiving Ferguson hemorrhoidectomy under spinal anesthesia

Exclusion Criteria:

• Allergy to local anesthetics or analgesics used in this study
• Drug abuse
• Coagulopathy
• An active infection at the injection site
• Patient refusal
• BMI ≥ 30
• Pregnancy