DataSheet1_The impact of combined administration of ropivacaine and dexamethasone on postoperative analgesia in perianal surgery with pudendal nerve block under ultrasound guidance: a prospective randomized controlled study.DOCX

BackgroundIn recent years, severe pain after perianal surgery has seriously affected the prognosis of hospitalized patients. How to maximize the improvement of postoperative pain and perioperative comfort becomes particularly important.
MethodsThis study was a double-blind randomized controlled trial (Registration No.: ChiCTR2100048760, Registration Date: 16 July 2021, Link: www.chictr.org.cn/showproj.html?proj=130226), and patients were randomly divided into two groups: one group underwent postoperative 20 mL bilateral pudendal nerve block with 0.5% ropivacaine (P group), and the other group underwent postoperative 20 mL bilateral pudendal nerve block with 0.5% ropivacaine + 8 mg dexamethasone (PD group). The primary outcome was the incidence of moderate to severe pain at the first postoperative dressing change. Secondary outcomes included Quality of recovery-15 (QoR-15) score at 3 days after surgery, sleep quality, pain score at 3 days after surgery, and incidence of adverse events.
ResultsIn the main outcome indicators, the incidence was 41.7% in the P group and 24.2% in the PD group (p = 0.01). The QoR-15 score and sleep quality in PD group were better than those in P group 2 days before surgery. The incidence of postoperative urinary retention was significantly decreased in PD group (p = 0.01).
ConclusionLocal anesthesia with dexamethasone combined with pudendal nerve block after perianal surgery can reduce the incidence of moderate to severe pain during the first dressing change. This may be one of the approaches to multimodal analgesia after perianal surgery.
Clinical Trial Registrationhttps://www.chictr.org.cn/, identifier ChiCTR2100048760.

背景：近年来，肛周术后剧烈疼痛严重影响住院患者的预后，如何最大程度改善术后疼痛与围手术期舒适度显得尤为关键。
方法：本研究为一项双盲随机对照试验（double-blind randomized controlled trial），注册编号：ChiCTR2100048760，注册日期：2021年7月16日，链接：www.chictr.org.cn/showproj.html?proj=130226。研究将患者随机分为两组：一组于术后给予0.5%罗哌卡因（ropivacaine）20mL行双侧阴部神经阻滞（P组），另一组于术后给予0.5%罗哌卡因联合8mg地塞米松（dexamethasone）20mL行双侧阴部神经阻滞（PD组）。本研究的主要结局指标为首次术后换药时中重度疼痛的发生率；次要结局指标包括术后3天的恢复质量量表-15（Quality of recovery-15，QoR-15）评分、睡眠质量、术后3天疼痛评分以及不良事件发生率。
结果：在主要结局指标中，P组中重度疼痛发生率为41.7%，PD组为24.2%（p=0.01）。PD组的QoR-15评分与睡眠质量在术前2天优于P组；PD组术后尿潴留发生率显著降低（p=0.01）。
结论：肛周术后联合地塞米松的阴部神经阻滞局部麻醉方案，可降低首次换药时中重度疼痛的发生率，这或可成为肛周术后多模式镇痛的可选方案之一。
临床试验注册：注册平台：https://www.chictr.org.cn/，识别编号：ChiCTR2100048760。