Pudendal nerve block versus sacral erector spinae (ESP) block for pain after hemorrhoidectomy

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

Hemorrhoidectomy commonly causes significant postoperative pain that can slow recovery and increase unplanned healthcare use. The PUSHES trial randomizes 64 adults undergoing elective excisional hemorrhoidectomy under standardized spinal anesthesia to receive either an ultrasound-guided sacral ESP block or a pudendal nerve block, with sham procedures to maintain blinding. Outcomes include postoperative pain scores, opioid consumption, and recovery metrics such as time to discharge. The sacral ESP block is a newer, potentially simpler ultrasound-guided technique that may offer easier performance and a favorable safety profile compared with the pudendal block.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Adults (≥18 years old) scheduled for elective excisional hemorrhoidectomy;
* Ability to understand the nature of the study and provide written informed consent;
* American Society of Anesthesiologists (ASA) physical status I-III;
* Ability to comply with study procedures and postoperative evaluations.

Exclusion Criteria:

* Pregnancy;
* Body weight under 50 kg due to the potential risk of local anaesthetic systemic toxicity (LAST);
* BMI \> 40; Known allergy or contraindication to local anaesthetics (e.g., ropivacaine, prilocaine);
* Severe coagulation disorders or current anticoagulant therapy contraindicating spinal or peripheral deep nerve blocks (like pudendal block, because Sacral ESP is considered a superficial block);
* Infection at the puncture site;
* Neurological disorders affecting the sacral or pudendal nerve pathways;
* Severe psychiatric conditions impairing study participation;
* Language barriers

Where it's running

• Ospedale Regionale Bellinzona e Valli (ORBV) CH-6500 Bellinzona Switzerland
  Bellinzona, Switzerland Recruiting

Study contacts

• Study coordinator: Roberto Dossi, Dr. Med.
• Email: Roberto.Dossi@eoc.ch
• Phone: 0041 (0)91 811

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.