xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05990569</url>
    </required_header>
    <id_info>
      <org_study_id>IRC-RP-2079/80-04</org_study_id>
      <nct_id>NCT05990569</nct_id>
    </id_info>
    <brief_title>Pudendal Nerve Block With Bupivacaine Alone and Bupivacaine With Methylene Blue for Postoperative Analgesia</brief_title>
    <official_title>A Randomized Comparative Study of Pudendal Nerve Block With Bupivacaine Alone and Bupivacaine With Methylene Blue for Postoperative Analgesia in Perianal Surgery</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Nepal Mediciti Hospital</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
    </sponsors>
    <source>Nepal Mediciti Hospital</source>
    <oversight_info>
      <has_dmc>Yes</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
      <is_us_export>No</is_us_export>
    </oversight_info>
    <brief_summary>
      <textblock>
        Study Description:&#xD;
  &#xD;
        The goal of this clinical trial is to compare the duration of postoperative pain relief&#xD;
        achieved with two different approaches to pudendal nerve block in patients undergoing&#xD;
        elective perianal surgery. The main question this study aims to answer is whether adding&#xD;
        Methylene Blue to Bupivacaine pudendal nerve block can prolong postoperative analgesia&#xD;
        compared to using Bupivacaine alone.&#xD;
  &#xD;
        Participants in this study will be individuals with ASA I and II physical status undergoing&#xD;
        elective perianal surgery under spinal anesthesia. They will be randomly assigned to one of&#xD;
        two groups:&#xD;
  &#xD;
          1. Group A (Case Group): Participants will receive a pudendal nerve block with Bupivacaine&#xD;
             combined with Methylene Blue.&#xD;
  &#xD;
          2. Group B (Control Group): Participants will receive a pudendal nerve block with&#xD;
             Bupivacaine alone.&#xD;
  &#xD;
        The pudendal nerve block will be performed using ultrasound guidance at the level of the&#xD;
        ischial spine. The needle tip will be positioned between the Sacro tuberous and sacrospinous&#xD;
        ligaments to inject the local anesthetic or the local anesthetic combined with Methylene&#xD;
        Blue.&#xD;
  &#xD;
        Throughout the study, the researchers will monitor the time to the first rescue analgesic,&#xD;
        assess pain levels using the Numeric Rating Scale at various time intervals (2, 6, 24, 48&#xD;
        hours, and 7 days), and observe for any side effects or complications related to the&#xD;
        intervention.&#xD;
  &#xD;
        Participants will be closely observed after surgery to assess their pain levels and analgesic&#xD;
        requirements. The researchers will also evaluate patient satisfaction using the Likert scale.&#xD;
  &#xD;
        By comparing the outcomes between the two groups, the study aims to determine if the addition&#xD;
        of Methylene Blue to Bupivacaine pudendal nerve block provides superior postoperative&#xD;
        analgesia in perianal surgery patients. This information will contribute to the understanding&#xD;
        of effective pain management strategies for individuals undergoing perianal surgical&#xD;
        procedures and potentially reduce the need for opioids and improve patient outcomes.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Study Description:&#xD;
  &#xD;
        The aim of this randomized comparative study is to investigate the effectiveness of two&#xD;
        different approaches to postoperative analgesia in patients undergoing perianal surgery. The&#xD;
        study will compare the use of Bupivacaine alone with Bupivacaine combined with Methylene Blue&#xD;
        in a pudendal nerve block.&#xD;
  &#xD;
        Perianal surgical procedures, such as abscess drainage, fistulectomy, and hemorrhoidectomy,&#xD;
        can cause significant postoperative pain. The goal of this study is to find a more effective&#xD;
        and prolonged method of pain relief to improve patient comfort and reduce the need for&#xD;
        opioids.&#xD;
  &#xD;
        Participants in this study will be individuals scheduled for elective perianal surgery and&#xD;
        classified as ASA I and II. They will be randomly assigned to one of two groups:&#xD;
  &#xD;
          1. Group A: Participants will receive a pudendal nerve block with Bupivacaine and Methylene&#xD;
             Blue.&#xD;
  &#xD;
          2. Group B: Participants will receive a pudendal nerve block with Bupivacaine alone.&#xD;
  &#xD;
        The pudendal nerve block will be performed under ultrasound guidance at the ischial spine&#xD;
        level. The needle will be accurately placed between the Sacro tuberous and sacrospinous&#xD;
        ligaments for precise injection of the local anesthetic or the local anesthetic combined with&#xD;
        Methylene Blue.&#xD;
  &#xD;
        Throughout the study, the researchers will closely monitor the participants to assess the&#xD;
        time to the first rescue analgesic and pain levels using the Numeric Rating Scale at specific&#xD;
        time intervals (2, 6, 24, 48 hours, and 7 days). Additionally, any side effects, allergies,&#xD;
        itching, hematoma, infection, or complications like loss of anal sphincter function will be&#xD;
        recorded.&#xD;
  &#xD;
        Patient satisfaction will also be evaluated using the Likert scale to determine the perceived&#xD;
        effectiveness of the different approaches to postoperative analgesia.&#xD;
  &#xD;
        By comparing the outcomes between the two groups, this study aims to determine whether the&#xD;
        addition of Methylene Blue to Bupivacaine in a pudendal nerve block can prolong postoperative&#xD;
        analgesia in patients undergoing perianal surgery. The findings from this study may&#xD;
        contribute valuable insights into improving pain management strategies and enhancing the&#xD;
        overall recovery experience for patients undergoing perianal surgical procedures.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Not yet recruiting</overall_status>
    <start_date type="Anticipated">August 2023</start_date>
    <completion_date type="Anticipated">July 2024</completion_date>
    <primary_completion_date type="Anticipated">June 2024</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <primary_purpose>Supportive Care</primary_purpose>
      <masking>None (Open Label)</masking>
    </study_design_info>
    <primary_outcome>
      <measure>Time to the first rescue analgesic administration (in minutes) in the two study groups</measure>
      <time_frame>48 hours</time_frame>
      <description>We will compare the time at which patients in either group will demand rescue analgesic</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Patient satisfaction assessed using the Likert scale after receiving Bupivacaine pudendal nerve block with or without Methylene Blue.</measure>
      <time_frame>Seven days</time_frame>
      <description>We will ask the patient to select one of the following satisfaction scores:&#xD;
  Very satisfied Moderately satisfied Neither satisfied nor dissatisfied Moderately dissatisfied Very dissatisfied</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>Numeric Rating Scale (NRS) score for pain intensity at different time intervals</measure>
      <time_frame>Seven days</time_frame>
      <description>Numeric Rating Scale (NRS) score for pain intensity will be measured at different time intervals (at 2, 6, 24, 48 hours, and 7 days) after surgery in both study groups.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Complications</measure>
      <time_frame>seven days</time_frame>
      <description>Incidence of complications related to the pudendal nerve block procedure, such as hematoma, infection, and allergic reactions will be captured when it is detected or at the end of seventh postoperative day</description>
    </secondary_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Anticipated">60</enrollment>
    <condition>Hemorrhoids</condition>
    <condition>Anal Fissure and Fistula</condition>
    <condition>Perianal Abscess</condition>
    <condition>Perianal Fistula</condition>
    <condition>Pilonidal Sinus</condition>
    <condition>Perianal Skin Tags</condition>
    <arm_group>
      <arm_group_label>Arm A</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Bupivacaine</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Arm B</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Bupivacaine with methylene blue</description>
    </arm_group>
    <intervention>
      <intervention_type>Other</intervention_type>
      <intervention_name>Ultrasound guided Pudendal nerve block</intervention_name>
      <description>Ultrasound guided bilateral pudendal nerve block</description>
      <arm_group_label>Arm A</arm_group_label>
      <arm_group_label>Arm B</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  All patients of ASA I and II undergoing elective perianal surgery under spinal&#xD;
               anesthesia&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            1. Patient's refusal&#xD;
  &#xD;
            2. Patient with a history of allergy to the local anesthetic or Methylene blue&#xD;
  &#xD;
            3. Bleeding diathesis or coagulopathy&#xD;
  &#xD;
            4. Extensive infection at the site of injection&#xD;
  &#xD;
            5. Pregnancy and lactating mother&#xD;
  &#xD;
            6. Spinal abnormality&#xD;
  &#xD;
            7. Patients with neurological deficit&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>15 Years</minimum_age>
      <maximum_age>90 Years</maximum_age>
      <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>Pragati Koirala, MD</last_name>
      <role>Principal Investigator</role>
      <affiliation>Nepal Mediciti</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>Apurb Sharma, MD</last_name>
      <phone>977-9841221467</phone>
      <email>apurbsharma1976@gmail.com</email>
    </overall_contact>
    <overall_contact_backup>
      <last_name>Prajjwal Bhattarai, MD</last_name>
      <phone>977-9851165664</phone>
      <email>prajjwal.bhattarai@gmail.com</email>
    </overall_contact_backup>
    <location>
      <facility>
        <name>Nepal Mediciti Hospital</name>
        <address>
          <city>Lalitpur</city>
          <zip>44700</zip>
          <country>Nepal</country>
        </address>
      </facility>
      <contact>
        <last_name>Apurb Sharma, MD</last_name>
        <phone>+9779841221467</phone>
        <email>apurbsharma1976@gmail.com</email>
      </contact>
      <investigator>
        <last_name>Saurav Raj Khatiwada, MD</last_name>
        <role>Principal Investigator</role>
      </investigator>
      <investigator>
        <last_name>Apurb Sharma, MD</last_name>
        <role>Sub-Investigator</role>
      </investigator>
      <investigator>
        <last_name>Prajjwal Raj Bhattarai, MD</last_name>
        <role>Sub-Investigator</role>
      </investigator>
    </location>
    <location_countries>
      <country>Nepal</country>
    </location_countries>
    <reference>
      <citation>Imbelloni LE, Vieira EM, Gouveia MA, Netinho JG, Spirandelli LD, Cordeiro JA. Pudendal block with bupivacaine for postoperative pain relief. Dis Colon Rectum. 2007 Oct;50(10):1656-61. doi: 10.1007/s10350-007-0216-7.</citation>
      <PMID>17701375</PMID>
    </reference>
    <reference>
      <citation>Sim HL, Tan KY. Randomized single-blind clinical trial of intradermal methylene blue on pain reduction after open diathermy haemorrhoidectomy. Colorectal Dis. 2014 Aug;16(8):O283-7. doi: 10.1111/codi.12587.</citation>
      <PMID>24506265</PMID>
    </reference>
    <reference>
      <citation>Naja Z, Ziade MF, Lonnqvist PA. Nerve stimulator guided pudendal nerve block decreases posthemorrhoidectomy pain. Can J Anaesth. 2005 Jan;52(1):62-8. doi: 10.1007/BF03018582.</citation>
      <PMID>15625258</PMID>
    </reference>
    <reference>
      <citation>Kunitake H, Poylin V. Complications Following Anorectal Surgery. Clin Colon Rectal Surg. 2016 Mar;29(1):14-21. doi: 10.1055/s-0035-1568145.</citation>
      <PMID>26929747</PMID>
    </reference>
    <reference>
      <citation>Ceulemans A, De Looze D, Van de Putte D, Stiers E, Coppens M. High post-operative pain scores despite multimodal analgesia in ambulatory anorectal surgery: a prospective cohort study. Acta Chir Belg. 2019 Aug;119(4):224-230. doi: 10.1080/00015458.2018.1500802. Epub 2018 Sep 7.</citation>
      <PMID>30189793</PMID>
    </reference>
    <reference>
      <citation>Garimella V, Cellini C. Postoperative pain control. Clin Colon Rectal Surg. 2013 Sep;26(3):191-6. doi: 10.1055/s-0033-1351138.</citation>
      <PMID>24436674</PMID>
    </reference>
    <reference>
      <citation>Abdi S, Shenouda P, Patel N, Saini B, Bharat Y, Calvillo O. A novel technique for pudendal nerve block. Pain Physician. 2004 Jul;7(3):319-22.</citation>
      <PMID>16858468</PMID>
    </reference>
    <reference>
      <citation>Ginimuge PR, Jyothi SD. Methylene blue: revisited. J Anaesthesiol Clin Pharmacol. 2010 Oct;26(4):517-20. No abstract available.</citation>
      <PMID>21547182</PMID>
    </reference>
    <reference>
      <citation>Lee SW, Han HC. Methylene Blue Application to Lessen Pain: Its Analgesic Effect and Mechanism. Front Neurosci. 2021 May 17;15:663650. doi: 10.3389/fnins.2021.663650. eCollection 2021.</citation>
      <PMID>34079436</PMID>
    </reference>
    <reference>
      <citation>Steen CJ, Lam D, Chandra R, Chua JYJ, An V, Keck JO. Pudendal Nerve Block for Posthemorrhoidectomy Pain: A Prospective, Single-Blinded Randomized Control Trial. Dis Colon Rectum. 2022 Apr 1;65(4):546-551. doi: 10.1097/DCR.0000000000002293.</citation>
      <PMID>34759239</PMID>
    </reference>
    <verification_date>August 2023</verification_date>
    <study_first_submitted>July 28, 2023</study_first_submitted>
    <study_first_submitted_qc>August 6, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 14, 2023</study_first_posted>
    <last_update_submitted>August 6, 2023</last_update_submitted>
    <last_update_submitted_qc>August 6, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 14, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>Nepal Mediciti Hospital</investigator_affiliation>
      <investigator_full_name>Saurav Raj Khatiwada</investigator_full_name>
      <investigator_title>Resident Doctor</investigator_title>
    </responsible_party>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Pilonidal Sinus</mesh_term>
      <mesh_term>Hemorrhoids</mesh_term>
      <mesh_term>Fissure in Ano</mesh_term>
      <mesh_term>Fistula</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>No</sharing_ipd>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05990569
  org study id: IRC-RP-2079/80-04
  nct id: NCT05990569
  lead sponsor: 
  has dmc: Yes
  is fda regulated drug: No
  is fda regulated device: No
  is us export: No
  Study Description:
  
        The goal of this clinical trial is to compare the duration of postoperative pain relief
        achieved with two different approaches to pudendal nerve block in patients undergoing
        elective perianal surgery. The main question this study aims to answer is whether adding
        Methylene Blue to Bupivacaine pudendal nerve block can prolong postoperative analgesia
        compared to using Bupivacaine alone.
  
        Participants in this study will be individuals with ASA I and II physical status undergoing
        elective perianal surgery under spinal anesthesia. They will be randomly assigned to one of
        two groups:
  
          1. Group A (Case Group): Participants will receive a pudendal nerve block with Bupivacaine
             combined with Methylene Blue.
  
          2. Group B (Control Group): Participants will receive a pudendal nerve block with
             Bupivacaine alone.
  
        The pudendal nerve block will be performed using ultrasound guidance at the level of the
        ischial spine. The needle tip will be positioned between the Sacro tuberous and sacrospinous
        ligaments to inject the local anesthetic or the local anesthetic combined with Methylene
        Blue.
  
        Throughout the study, the researchers will monitor the time to the first rescue analgesic,
        assess pain levels using the Numeric Rating Scale at various time intervals (2, 6, 24, 48
        hours, and 7 days), and observe for any side effects or complications related to the
        intervention.
  
        Participants will be closely observed after surgery to assess their pain levels and analgesic
        requirements. The researchers will also evaluate patient satisfaction using the Likert scale.
  
        By comparing the outcomes between the two groups, the study aims to determine if the addition
        of Methylene Blue to Bupivacaine pudendal nerve block provides superior postoperative
        analgesia in perianal surgery patients. This information will contribute to the understanding
        of effective pain management strategies for individuals undergoing perianal surgical
        procedures and potentially reduce the need for opioids and improve patient outcomes.
  Study Description:
  
        The aim of this randomized comparative study is to investigate the effectiveness of two
        different approaches to postoperative analgesia in patients undergoing perianal surgery. The
        study will compare the use of Bupivacaine alone with Bupivacaine combined with Methylene Blue
        in a pudendal nerve block.
  
        Perianal surgical procedures, such as abscess drainage, fistulectomy, and hemorrhoidectomy,
        can cause significant postoperative pain. The goal of this study is to find a more effective
        and prolonged method of pain relief to improve patient comfort and reduce the need for
        opioids.
  
        Participants in this study will be individuals scheduled for elective perianal surgery and
        classified as ASA I and II. They will be randomly assigned to one of two groups:
  
          1. Group A: Participants will receive a pudendal nerve block with Bupivacaine and Methylene
             Blue.
  
          2. Group B: Participants will receive a pudendal nerve block with Bupivacaine alone.
  
        The pudendal nerve block will be performed under ultrasound guidance at the ischial spine
        level. The needle will be accurately placed between the Sacro tuberous and sacrospinous
        ligaments for precise injection of the local anesthetic or the local anesthetic combined with
        Methylene Blue.
  
        Throughout the study, the researchers will closely monitor the participants to assess the
        time to the first rescue analgesic and pain levels using the Numeric Rating Scale at specific
        time intervals (2, 6, 24, 48 hours, and 7 days). Additionally, any side effects, allergies,
        itching, hematoma, infection, or complications like loss of anal sphincter function will be
        recorded.
  
        Patient satisfaction will also be evaluated using the Likert scale to determine the perceived
        effectiveness of the different approaches to postoperative analgesia.
  
        By comparing the outcomes between the two groups, this study aims to determine whether the
        addition of Methylene Blue to Bupivacaine in a pudendal nerve block can prolong postoperative
        analgesia in patients undergoing perianal surgery. The findings from this study may
        contribute valuable insights into improving pain management strategies and enhancing the
        overall recovery experience for patients undergoing perianal surgical procedures.
  allocation: Randomized
  intervention model: Parallel Assignment
  primary purpose: Supportive Care
  masking: None (Open Label)
  measure: Time to the first rescue analgesic administration (in minutes) in the two study groups
  time frame: 48 hours
  description: We will compare the time at which patients in either group will demand rescue analgesic
  measure: Patient satisfaction assessed using the Likert scale after receiving Bupivacaine pudendal nerve block with or without Methylene Blue.
  time frame: Seven days
  description: We will ask the patient to select one of the following satisfaction scores:
  Very satisfied Moderately satisfied Neither satisfied nor dissatisfied Moderately dissatisfied Very dissatisfied
  measure: Numeric Rating Scale (NRS) score for pain intensity at different time intervals
  time frame: Seven days
  description: Numeric Rating Scale (NRS) score for pain intensity will be measured at different time intervals (at 2, 6, 24, 48 hours, and 7 days) after surgery in both study groups.
  measure: Complications
  time frame: seven days
  description: Incidence of complications related to the pudendal nerve block procedure, such as hematoma, infection, and allergic reactions will be captured when it is detected or at the end of seventh postoperative day
  arm group label: Arm A
  arm group type: Experimental
  description: Bupivacaine
  arm group label: Arm B
  arm group type: Experimental
  description: Bupivacaine with methylene blue
  intervention type: Other
  intervention name: Ultrasound guided Pudendal nerve block
  description: Ultrasound guided bilateral pudendal nerve block
  arm group label: Arm A
  arm group label: Arm B
  criteria: 
  gender: All
  minimum age: 15 Years
  maximum age: 90 Years
  healthy volunteers: Accepts Healthy Volunteers
  last name: Pragati Koirala, MD
  role: Principal Investigator
  affiliation: Nepal Mediciti
  last name: Apurb Sharma, MD
  phone: 977-9841221467
  email: apurbsharma1976@gmail.com
  last name: Prajjwal Bhattarai, MD
  phone: 977-9851165664
  email: prajjwal.bhattarai@gmail.com
  facility: 
  contact: 
  investigator: 
  investigator: 
  investigator: 
  country: Nepal
  citation: Imbelloni LE, Vieira EM, Gouveia MA, Netinho JG, Spirandelli LD, Cordeiro JA. Pudendal block with bupivacaine for postoperative pain relief. Dis Colon Rectum. 2007 Oct;50(10):1656-61. doi: 10.1007/s10350-007-0216-7.
  PMID: 17701375
  citation: Sim HL, Tan KY. Randomized single-blind clinical trial of intradermal methylene blue on pain reduction after open diathermy haemorrhoidectomy. Colorectal Dis. 2014 Aug;16(8):O283-7. doi: 10.1111/codi.12587.
  PMID: 24506265
  citation: Naja Z, Ziade MF, Lonnqvist PA. Nerve stimulator guided pudendal nerve block decreases posthemorrhoidectomy pain. Can J Anaesth. 2005 Jan;52(1):62-8. doi: 10.1007/BF03018582.
  PMID: 15625258
  citation: Kunitake H, Poylin V. Complications Following Anorectal Surgery. Clin Colon Rectal Surg. 2016 Mar;29(1):14-21. doi: 10.1055/s-0035-1568145.
  PMID: 26929747
  citation: Ceulemans A, De Looze D, Van de Putte D, Stiers E, Coppens M. High post-operative pain scores despite multimodal analgesia in ambulatory anorectal surgery: a prospective cohort study. Acta Chir Belg. 2019 Aug;119(4):224-230. doi: 10.1080/00015458.2018.1500802. Epub 2018 Sep 7.
  PMID: 30189793
  citation: Garimella V, Cellini C. Postoperative pain control. Clin Colon Rectal Surg. 2013 Sep;26(3):191-6. doi: 10.1055/s-0033-1351138.
  PMID: 24436674
  citation: Abdi S, Shenouda P, Patel N, Saini B, Bharat Y, Calvillo O. A novel technique for pudendal nerve block. Pain Physician. 2004 Jul;7(3):319-22.
  PMID: 16858468
  citation: Ginimuge PR, Jyothi SD. Methylene blue: revisited. J Anaesthesiol Clin Pharmacol. 2010 Oct;26(4):517-20. No abstract available.
  PMID: 21547182
  citation: Lee SW, Han HC. Methylene Blue Application to Lessen Pain: Its Analgesic Effect and Mechanism. Front Neurosci. 2021 May 17;15:663650. doi: 10.3389/fnins.2021.663650. eCollection 2021.
  PMID: 34079436
  citation: Steen CJ, Lam D, Chandra R, Chua JYJ, An V, Keck JO. Pudendal Nerve Block for Posthemorrhoidectomy Pain: A Prospective, Single-Blinded Randomized Control Trial. Dis Colon Rectum. 2022 Apr 1;65(4):546-551. doi: 10.1097/DCR.0000000000002293.
  PMID: 34759239
  responsible party type: Principal Investigator
  investigator affiliation: Nepal Mediciti Hospital
  investigator full name: Saurav Raj Khatiwada
  investigator title: Resident Doctor
  mesh term: Pilonidal Sinus
  mesh term: Hemorrhoids
  mesh term: Fissure in Ano
  mesh term: Fistula
  sharing ipd: No