Ver el código de «Nerve block: perianal block»

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==Overview==

[[File:Gray542.png|thumb|Perineal innervation.]]
*Perianal blocks have been shown to be comparable to general anesthesia for in terms of pain control in anal procedures including surgeries <ref>Gerjy, R. et al. Randomized clinical trial of stapled haemorrhoidopexy performed under local perianal block versus general anaesthesia. Br J Surgy. 2008; 95(11):1344-51.</ref>
*"Perianal block is a safe, feasible, reliable, and reproducible mode of anesthesia." <ref>Bharathi, R. et al. Evidence based switch to perianal block for ano-rectal surgeries. International Journal of Surgery. 2010; 8:29–31</ref>


==Indications==

*[[Special:MyLanguage/Rectal foreign body|Rectal foreign body]] removal
*[[Special:MyLanguage/External hemorrhoid excision|External hemorrhoid excision]]
*[[Special:MyLanguage/Rectal prolapse|Rectal prolapse]]
*[[Special:MyLanguage/Anorectal abscess|Anorectal abscess]]


==Contraindications==

*Overlying infection
*Allergy to chosen anesthetic
*Uncooperative patient


==Equipment Needed==

*20 cc Syringe with a 27 Gauge Needle
*Spare 18 Gauge Needle (to draw up anesthetic)
*Local Anesthetic (e.g. [[Special:MyLanguage/Lidocaine|Lidocaine]] or [[Special:MyLanguage/Bupivacaine|Bupivacaine]])
*Silk Tape
*Pillow or Blankets 
*Packaged, Moist Towelette


==Procedure<ref>Nystrom, PO. et al. Local perianal block for anal surgery. Tech Coloproctol. 2004; 8(1):23-6</ref>==

*Obtain informed consent
*Place the patient in the prone position, placing either a pillow or blankets under their hips for comfort and ideal positioning
*Using tape, separate the patient's buttocks from one another to better visualize the perianal area
*Draw up anesthetic into 20 cc syringe using 18 Gauge Needle
*Ensure that the perianal area is clean by removing debris with moist towelette
*Peripheral to the anal sphincter, choose multiple injection sites that allow for fanning circumferentially around the anus
*Advance 27 Gauge needle into one of these preselected areas
*Aspirate to rule out intravascular placement prior to injecting 3 -5 mL of anesthetic
*Continue to the other preselected areas, fanning the needle circumferentially in order to surround the anal area with local anesthetic


==Complications==


==See Also==

*[[Special:MyLanguage/Nerve and regional blocks (main)|Nerve and regional blocks (main)]]


==External Links==


==References==

<References/>

[[Category:Procedures]]
[[Category:GI]]
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