Saddle block anaesthesia with meperidine for perineal surgery

Background and Aim: Regional (saddle block) anaesthesia in anorectal and some urological and gynaecological procedures provides suitable conditions for the surgeon due to the sufficiency of analgesia and decreases the side effects of spinal anaesthesia. In this study, duration of the painless period and complications after saddle block with Meperidine (pethidine) were assessed in perineal surgeries. Materials and Methods:This study was conducted on 50 cases observed by the American Society of Anaesthesiologists (ASA) physical status class I, II( 21-70 years old patients), who were scheduled to undergo anorectal surgery. All patients received 500ml of crystalloid solution. The saddle block was done with 30 mg pethidine and sub arachnoid puncture was performed with the patient in the sitting position. Vital signs were recorded 5 minutes before the block and at the 5th, 10th, 15th and 60th minutes after the block. The severity of postoperative pain was assessed by a visual analog scale. The data was analyzed by appropriate descriptive statistical methods. Results: The mean period of analgesia was more than 24 hours in 18% of the patients. The VAS pain score showed no pain in78% of the patients. Sixteen percent of the patients complained of itching in the nose, face and chest, ten minutes after injection and it continued for about two hours. Conclusions: This study showed that the haemodynamic stability and quality of postoperative analgesia with pethidine was good, without any need for additional analgesia. We suggested using low dosage pethidine (30 mg) as saddle block for perineal and anorectal surgeries