Comparison of Saddle Block Anesthesia with Three Different Sitting Times in Patients Undergoing Dilation and Curettage
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Abstract
Background: The advantages of using saddle block anesthesia have been established in certain surgical procedures; however, its application in patients undergoing dilation and curettage (D&C) has not yet been thoroughly investigated. Given the urgent nature of this procedure, it was necessary to compare the patient’s sitting time. Accordingly, the present study was conducted to compare saddle block anesthesia with three different sitting times in patients undergoing D&C.
Methods: The current randomized, double-blind clinical trial was conducted at Shahid Beheshti Hospital in the city of Isfahan in 2024. Forty-five patients were randomly allocated to three groups. In the first group, patients remained seated for 3 minutes; in the second group, for 4 minutes; and in the third group, for 5 minutes following the injection of Marcaine (bupivacaine). Data were collected using a checklist and analyzed using SPSS version 26.
Results: There were no significant differences among the three groups in terms of age, gestational age, length of hospital stay, and maximum sensory block level (P > 0.05). However, a significant difference was observed between gestational age and pain intensity among the three groups (P < 0.05). Blood pressure (systolic and diastolic) and heart rate showed no significant differences among the three groups (P > 0.05).
Conclusion: Sitting patients undergoing D&C after saddle block anesthesia for 3, 4, or 5 minutes had no significant effect on any of the measured variables, including pain, systolic blood pressure, diastolic blood pressure, and heart rate. Notably, according to the results, if a pregnant woman is beyond 15 weeks of gestation, it is advisable for her to remain seated for 5 minutes after the saddle block to minimize pain intensity, as shorter sitting times will culminate in greater pain intensity.
[2] Jones RK, Jerman J. Abortion Incidence and Service Availability In the United States, 2014. Perspect Sex Reprod Health. 2017 Mar;49(1):17-27.
[3] Qiu J, Fu Y, Xu J. Analysis on clinical effects of dilation and curettage guided by ultrasonography versus hysteroscopy after uterine artery embolization in the treatment of cesarean scar pregnancy. Ther Clin Risk Manag. 2019; 15: 83–89.
[4] Margaliot Kalifa T, Lang Ben Nun E. Maternal and Neonatal Outcomes of Women Conceived Less Than 6 Months after First Trimester Dilation and Curettage. J Clin Med. 2022; 11(10): 2767.
[5] Hooker AB, de Leeuw RA, Twisk JWR, Brölmann HAM, Huirne JAF. Reproductive performance of women with and without intrauterine adhesions following recurrent dilatation and curettage for miscarriage: long-term follow-up of a randomized controlled trial. Hum Reprod. 2021; 36(1):70-81.
[6] Margaliot Kalifa T, Srebnik N, Sela HY, Armon S, Grisaru-Granovsky S, Rottenstreich M. Impact of first-trimester mechanical cervical dilatation during curettage on maternal and neonatal outcomes: A retrospective comparative study. Eur J Obstet Gynecol Reprod Biol. 2024; 300:1-5.
[7] Carlson A, Ehrig JC, Hammonds K, Hofkamp MP. Choice of anesthetic technique for dilation and curettage for indication of pregnancy loss. Proc (Bayl Univ Med Cent). 2022; 35(6):751-754.
[8] Nazemroaya B, Jabalameli M, Kamali A. Assessing the effects of dexmedetomidine and labetalol on changes in heart rate and blood pressure after laryngoscopy compared to a control group. J Cell Mol Anesth. 2020; 5(2):e149597.
[9] Conn AM, Turrentine MA, Davis BR. Impact of route of anesthesia on estimated blood deficit with dilation and curettage for early pregnancy loss: a retrospective cohort study. J Clin Anesth. 2020;66: 109784.
[10] Kamran Z, Nazemroaya B. The intravenous injection of pethidine and dexmedetomidine in the prevention of cesarean postoperative shivering under spinal anesthesia: A double-blind clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2022; 25(6): 52-60.
[11] Ghosouri A, Jabalameli M, Nazemroaya B, Najafian R. Effect of intravenous administration of atropine-neostigmine versus ondansetron in prevention postdural puncture headache in cesarean section under spinal: a randomized clinical trial. Tehran Univ Med J 2023; 81 (7) :503-513
[12] Zengin Emine N, Yalnız Kudret Y. Comparison of Different Local Anesthetic Volumes for Saddle Block Anesthesia in Ambulatory Surgery: A Prospective Randomized Trial. Cureus. 2023; 15(6): e41063.
[13] Ring L, Landau R. The Current Role of General Anesthesia for Cesarean Delivery. Curr Anesthesiol Rep. 2021; 11(1): 18–27.
[14] Rahmati J, Shahriari M, Shahriari A. Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia. Anesth Pain Med. 2021; 11(2): e113350.
[15] Skarlus Doelakeh E, Chandak A. Risk Factors in Administering Spinal Anesthesia: A Comprehensive Review. Cureus. 2023; 15(12): e49886.
[16] Hoon Kim Y, Young Kwon S. Comparison of epidural, spinal, and saddle block for holmium laser enucleation of prostate (HoLEP). Medicine (Baltimore). 2021; 100(42): e27534.
[17] Lam K K, Leung M K M, Irwin M G. Labour analgesia: update and literature review. Hong Kong Med J. 2020; 26(5):413-420.
[18] Brooks Peterson M, Strupp KM, Brockel MA, Wilder MS, Zieg J, Bruckner AL, et al. Anesthetic Management and Outcomes of Patients with Epidermolysis Bullosa: Experience at a Tertiary Referral Center. Anesth Analg. 2022; 134(4):810-821.
[19] Bhattacharyya A, Laycock H, Brett SJ, Beatty F, Kemp HI. Health care professionals' experiences of pain management in the intensive care unit: a qualitative study. Anaesthesia. 2024; 79(6):611-626.
[20] Sikakulya FK, Ssebuufu R, Okedi XF, Baluku M, Lule H, Kiyaka SM,.et al. Local anesthesia versus saddle block for open hemorrhoidectomy: cost-analysis from a randomized, double blind controlled trial. BMC Health Serv Res. 2023; 23:1283.
[21] Yung EM, Abdallah FW, Todaro C, Spence E, Grant A, Brull R. Optimal local anesthetic regimen for saddle block in ambulatory anorectal surgery: an evidence-based systematic review. Reg Anesth Pain Med. 2020; 45(9):733-739.
[22] Shahid N, Iqbal MW, Haque SN, Rashid AM, Shaukat S. Effectiveness of Saddle Block Vs Spinal Anaesthesia In Turp: An Open Label Randomized Control Trial. J Ayub Med Coll Abbottabad. 2023; 35(1):127-132.
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