Condition 1: Hemorrhoids. Condition 2: Fissure and fistula of anal and rectal regions. Hemorrhoids and perianal venous thrombosis Fissure and fistula of anal and rectal regions
Conditions
Interventions
Intervention 1: Intervention Group: Spinal Group. Spinal anesthesia will be performed under completely sterile conditions, in the sitting position, using a 25-gauge Quincke needle. The needle will be
if pain persists, 2 mg IV morphine. If morphine is given, patient stays in recovery at least one hour post-administration. Clinical status evaluated every 30 minutes via Marshall criteria. Discharge f
Sponsors
Tehran University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Inclusion criteria
Inclusion criteria: Age 20 to 60 years ASA class I & II Type of surgery: Fissure, fistula or hemorrhoid Informed consent to participate in the plan
Exclusion criteria
Exclusion criteria: Sensitivity to anesthesia drugs used in the plan Failure of the selected method Patient position for lithotomy surgery not be Patient dissatisfaction for receiving spinal anesthesia Localized sepsis at the site of spinal Patient inability to remain immobile during spinal procedure Patient with high intra-abdominal pressure Myelopathy or peripheral neuropathy Spinal canal stenosis History of spinal column surgery in the range of spinal procedure Multiple sclerosis Spina bifida Aortic valve stenosis or fixed cardiac output Hypovolemia Thromboprophylaxis consumption in a time frame less than allowed for spinal Inherited coagulation disorder Consumption of addictive substances Surgery duration more than 90 minutes
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time to discharge readiness (based on achieving a minimum score of 9 on the Marshall criteria, assessed every 30 minutes in recovery). Timepoint: Time to discharge readiness, assessed every 30 minutes in recovery post-surgery until achieving a minimum score of 9 on the Marshall criteria. Method of measurement: Measurement method: Time to discharge readiness is assessed every 30 minutes in recovery using the Marshall criteria (Miller’s Anesthesia, 9th edition, 2020). Patients undergo standard monitoring (blood pressure, heart rate, oxygen saturation), and sensory level in the spinal group is evaluated with cold, pinprick, and touch tests. Data are analyzed using SPSS software. | — |
Secondary
| Measure | Time frame |
|---|---|
| Postoperative pain intensity. Timepoint: Immediately after surgery and every 30 minutes in recovery until discharge. Method of measurement: Numerical Rating Scale from 0 to 10.;Analgesic use in recovery. Timepoint: During patient’s stay in recovery post-surgery. Method of measurement: Recording dose and type of analgesic (ketorolac 30 milligrams intramuscularly or morphine 2 milligrams intravenously).;Postoperative shivering. Timepoint: During patient’s stay in recovery post-surgery. Method of measurement: Clinical observation and documentation of shivering by recovery staff. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactReza Effatdoost Astane
Tehran University of Medical Sciences
Outcome results
None listed