@article{article_1766511, title={Comparison of anesthesia techniques in laser hemorrhoid surgery: pudendal nerve block vs. spinal anesthesia}, journal={Journal of Medicine and Palliative Care}, volume={6}, pages={496–501}, year={2025}, DOI={10.47582/jompac.1766511}, author={Evirgen, Suat and Duran, Harun Tolga and Çetin, Şirin}, keywords={Laser hemorrhoidoplasty, pudendal nerve block, spinal anesthesia, postoperative pain, patient satisfaction}, abstract={Aims: Laser hemorrhoidoplasty (LHP) is a minimally invasive surgical procedure gaining popularity due to its low complication rate and rapid recovery. However, issues such as postoperative pain and urinary retention continue to adversely affect patient comfort. This study aimed to evaluate the effects of ultrasound-guided pudendal nerve block (PNB) under propofol sedation, compared to spinal anesthesia (SA), on postoperative pain control, analgesic requirement, urinary retention incidence, and patient satisfaction. Methods: A prospective, randomized, controlled trial was conducted at Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital. Ninety-six patients diagnosed with grade 2–3 hemorrhoidal disease and scheduled for elective LHP were enrolled. Patients were divided into two groups: the PNB group (n=48) received PNB under propofol sedation, and the SA group (n=48) received SA. Postoperative pain intensity was assessed using the Visual Analog Scale (VAS) at 2, 4, 8, 16, 48, and 72 hours. Secondary outcomes included total analgesic consumption, urinary retention incidence, and patient satisfaction. Results: At all time points, VAS scores were significantly lower in the PNB group compared to the SA group (p <0.001). Total analgesic consumption during the first 72 hours was markedly reduced in the PNB group (p <0.001). The incidence of urinary retention was 4.2% in the PNB group versus 22.9% in the SA group, demonstrating a significant difference (p <0.001). Patient satisfaction was significantly higher in the PNB group (p <0.001). Conclusion: Ultrasound-guided PNB combined with propofol sedation provides superior postoperative pain control, reduces analgesic requirements, and lowers complication rates compared to SA in laser hemorrhoid surgery. This technique represents an effective and safe alternative that enhances patient satisfaction.}, number={5}, publisher={MediHealth Academy Yayıncılık}