714
document
Local injection of bupivacaine after rubber band ligation of hemorrhoids : prospective , randomized study . PURPOSE The aim of this study was to determine if local injection of bupivacaine after hemorrhoidal banding causes a decrease in pain and in the incidence of associated symptoms . METHODS After hemorrhoidal banding , patients were randomly assigned to receive a local injection of bupivacaine with 1:200,000 epinephrine , an injection of normal saline , or no injection , just superior to each band . Pain was graded by the patient and by the study nurse within 30 minutes , and any associated symptoms were recorded . At intervals 6 , 24 , and 48 hours postbanding , the patient recorded pain , limitation of activities , and analgesic requirements . Associated symptoms while at home were recorded . RESULTS Of 115 patients studied , 42 received bupivacaine injection , 42 received normal saline injection , and 31 received no injection . In patients receiving bupivacaine compared with no injection , within 30 minutes postbanding there was a significant reduction in pain graded by the patient ( P = 0.000002 ) and by the nurse ( P = 0.000005 ) and a significant reduction in incidence of nausea ( P = 0.01 ) and shaking ( P = 0.008 ) . However , in the bupivacaine group compared with the other two groups , at the intervals of 6 , 24 , and 48 hours postbanding there was no sustained reduction in the severity of pain and no reduction in analgesic requirements or limitation of normal activities . In the week after banding , there was no difference between groups in symptoms of nausea , shaking , lightheadedness , urinary retention , or bleeding . CONCLUSIONS Bupivacaine injection may be useful for reducing pain and associated symptoms long enough to tolerate a trip home from the outpatient department but does not show a sustained effect .
715
Intervention_Pharmacological
bupivacaine
716
Intervention_Pharmacological
bupivacaine
717
Intervention_Pharmacological
local injection of bupivacaine with 1:200,000 epinephrine
718
Intervention_Pharmacological
injection of normal saline
719
Intervention_Control
no injection , just
720
Intervention_Pharmacological
bupivacaine
721
Intervention_Control
normal saline
722
Intervention_Control
no injection
723
Intervention_Pharmacological
bupivacaine
724
Intervention_Pharmacological
bupivacaine
725
Intervention_Pharmacological
Bupivacaine
726
Outcome_Pain
decrease in pain and in the incidence of associated symptoms .
727
Outcome_Pain
Pain
728
Outcome_Physical
associated symptoms
729
Outcome_Pain
pain , limitation of activities , and analgesic requirements .
730
Outcome_Physical
Associated symptoms
731
Outcome_Pain
reduction in pain
732
Outcome_Adverse-effects
incidence of nausea
733
Outcome_Pain
severity of pain
734
Outcome_Pain
analgesic requirements or limitation of normal activities .
735
Outcome_Physical
nausea , shaking , lightheadedness , urinary retention , or bleeding .
736
Participant_Condition
hemorrhoids
737
Participant_Condition
hemorrhoidal banding
738
Participant_Sample-size
115