{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T08:18:17Z","timestamp":1770884297678,"version":"3.50.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2010,1,1]],"date-time":"2010-01-01T00:00:00Z","timestamp":1262304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The aim of this randomized clinical trial was to determine whether spinal saddle block (SSB) is superior to total intravenous anaesthesia (TIVA) in perianal surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Suitable patients aged 18\u201375 years (American Society of Anesthesiologists grade I or II) scheduled to undergo perianal surgery were randomized to SSB (1\u00b70 ml 0\u00b75 per cent hyperbaric bupivacaine) or TIVA with propofol and fentanyl by means of a laryngeal mask. Cumulative consumption of analgesics within 24 h after surgery was recorded, and postoperative recovery and patient satisfaction were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 201 patients were randomized. Supplemental analgesia within 24 h after surgery was required by 31 of 101 patients having SSB and 58 of 100 who had TIVA (P &amp;lt; 0\u00b7001). Median monitoring time in the recovery room was 5 (range 1\u201345) min for SSB versus 44 (4\u2013148) min for TIVA (P &amp;lt; 0\u00b7001). Patients in the SSB group were able to eat and drink more quickly, although times to mobilization and micturition were not significantly different. Patients having SSB were more likely to describe the anaesthesia as \u2018better than expected\u2019.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>SSB is superior to TIVA in patients undergoing perianal surgery in terms of analgesic consumption within 24 h after surgery and aspects of postoperative recovery. Registration number: ISRCTN41981381 (http:\/\/www.controlled-trials.com).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.6792","type":"journal-article","created":{"date-parts":[[2009,11,24]],"date-time":"2009-11-24T12:33:37Z","timestamp":1259066017000},"page":"12-20","source":"Crossref","is-referenced-by-count":43,"title":["Randomized clinical trial of perianal surgery performed under spinal saddle block <i>versus<\/i> total intravenous anaesthesia"],"prefix":"10.1093","volume":"97","author":[{"given":"M D","family":"Schmittner","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Surgical Intensive Care Medicine , Mannheim,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Surgical Intensive Care Medicine , Mannheim,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Janke","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Surgical Intensive Care Medicine , Mannheim,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, University Medical Centre Mannheim , Mannheim,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Blunk","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Surgical Intensive Care Medicine , Mannheim,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D G","family":"Bussen","sequence":"additional","affiliation":[{"name":"Department of Centre of Coloproctology , Mannheim,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Luecke","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Surgical Intensive Care Medicine , Mannheim,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2010,1,1]]},"reference":[{"key":"2024093006455166800_bib1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1007\/BF02049406","article-title":"Symptomatic hemorrhoids: current incidence and complications of operative therapy","volume":"35","author":"Bleday","year":"1992","journal-title":"Dis Colon Rectum"},{"key":"2024093006455166800_bib2","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1002\/bjs.6078","article-title":"Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy","volume":"95","author":"Shao","year":"2008","journal-title":"Br J Surg"},{"key":"2024093006455166800_bib3","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jclinane.2006.12.004","article-title":"Local anesthetic infiltration versus caudal epidural block for anorectal surgery: a randomized controlled trial","volume":"19","author":"Siddiqui","year":"2007","journal-title":"J Clin Anesth"},{"key":"2024093006455166800_bib4","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1097\/00000542-200011000-00015","article-title":"Comparison of the costs and recovery profiles of three anesthetic techniques for ambulatory anorectal surgery","volume":"93","author":"Li","year":"2000","journal-title":"Anesthesiology"},{"key":"2024093006455166800_bib5","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1097\/00000539-200211000-00028","article-title":"Small-dose intrathecal lidocaine versus ropivacaine for anorectal surgery in an ambulatory setting","volume":"95","author":"Buckenmaier","year":"2002","journal-title":"Anesth Analg"},{"key":"2024093006455166800_bib6","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1213\/01.ane.0000261510.37489.00","article-title":"Spinal perianal block: a prospective, randomized, double-blind comparison with spinal saddle block","volume":"104","author":"Wassef","year":"2007","journal-title":"Anesth Analg"},{"key":"2024093006455166800_bib7","first-page":"457","article-title":"Datenanforderungen auf dem Personalsektor zur Abbildung von Prozessen im OP und zur Kalkulation der DRGs","volume":"43","author":"Deutsche Gesellschaft f\u00fcr Anaesthesiologie und Intensivmedizin\/Berufsverband Deutscher Anaesthesisten","year":"2002","journal-title":"An\u00e4sth Intensivmed"},{"key":"2024093006455166800_bib8","first-page":"244","article-title":"Validity and reliability of the Observer's Assessment of Alertness\/Sedation Scale: study with intravenous midazolam","volume":"10","author":"Chernik","year":"1990","journal-title":"J Clin Psychopharmacol"},{"key":"2024093006455166800_bib9","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1213\/00000539-197011000-00020","article-title":"A postanesthetic recovery score","volume":"49","author":"Aldrete","year":"1970","journal-title":"Anesth Analg"},{"key":"2024093006455166800_bib10","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1093\/bja\/88.5.659","article-title":"Volatile anaesthetics are the main cause of early postoperative vomiting: a randomized controlled trial of factorial design","volume":"88","author":"Apfel","year":"2002","journal-title":"Br J Anaesth"},{"key":"2024093006455166800_bib11","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/j.1399-6576.2005.00650.x","article-title":"Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery","volume":"49","author":"Rama-Maceiras","year":"2005","journal-title":"Acta Anaesthesiol Scand"},{"key":"2024093006455166800_bib12","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1097\/00000542-200109000-00012","article-title":"Randomized controlled trial of total intravenous anesthesia with propofol versus inhalation anesthesia with isoflurane\u2013nitrous oxide","volume":"95","author":"Visser","year":"2001","journal-title":"Anesthesiology"},{"key":"2024093006455166800_bib13","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1097\/ACO.0b013e3282f021c9","article-title":"Evidence-based medicine in day surgery","volume":"20","author":"Gupta","year":"2007","journal-title":"Curr Opin Anaesthesiol"},{"key":"2024093006455166800_bib14","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1097\/00000542-200302000-00036","article-title":"Postoperative nausea and vomiting in regional anaesthesia: a review","volume":"98","author":"Borgeat","year":"2003","journal-title":"Anesthesiology"},{"key":"2024093006455166800_bib15","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1111\/j.1399-6576.1997.tb04783.x","article-title":"Grading of severity of postdural puncture headache after 27-gauge Quincke and Whitacre needles","volume":"41","author":"Corbey","year":"1997","journal-title":"Acta Anesthesiol Scand"},{"key":"2024093006455166800_bib16","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/bja\/aei008","article-title":"Comparison of plain and hyperbaric solutions of ropivacain for spinal anesthesia","volume":"94","author":"Fettes","year":"2005","journal-title":"Br J Anaesth"},{"key":"2024093006455166800_bib17","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1093\/bja\/88.2.215","article-title":"Rectal and parenteral paracetamol, and paracetamol in combination with NSAIDs, for postoperative analgesia","volume":"88","author":"R\u00f8msing","year":"2002","journal-title":"Br J Anaesth"},{"key":"2024093006455166800_bib18","first-page":"384","article-title":"Predicting the difficult neurexial block: a prospective study","volume":"89","author":"Sprung","year":"1999","journal-title":"Anesth Analg"},{"key":"2024093006455166800_bib19","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1017\/S0265021502000716","article-title":"Predictors of successful neurexial block: a prospective study","volume":"19","author":"de Filho","year":"2002","journal-title":"J Eur Anaesthesiol"},{"key":"2024093006455166800_bib20","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1093\/bja\/aeg077","article-title":"Comparison of ropivacaine 0\u00b75% (in glucose 5%) with bupivacaine 0\u00b75% (in glucose 8%) for spinal anaesthesia for elective surgery","volume":"90","author":"Whiteside","year":"2003","journal-title":"Br J Anaesth"},{"key":"2024093006455166800_bib21","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1093\/bja\/aen250","article-title":"Spinal anaesthesia for elective surgery: a comparison of hyperbaric solutions of racemic bupivacaine, levobupivacaine, and ropivacaine","volume":"101","author":"Luck","year":"2008","journal-title":"Br J Anaesth"},{"key":"2024093006455166800_bib22","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1093\/bja\/88.4.582","article-title":"Postoperative sore throat after ambulatory surgery","volume":"88","author":"Higgins","year":"2002","journal-title":"Br J Anaesth"},{"key":"2024093006455166800_bib23","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1213\/00000539-196111000-00027","article-title":"Postoperative backache","volume":"40","author":"Brown","year":"1961","journal-title":"Anesth Analg"},{"key":"2024093006455166800_bib24","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/0002-9610(57)90629-3","article-title":"Urinary retention in anorectal and colonic surgery","volume":"94","author":"Salvati","year":"1957","journal-title":"Am J Surg"},{"key":"2024093006455166800_bib25","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1001\/archsurg.1975.01360180076017","article-title":"Catheterization in anorectal surgery","volume":"110","author":"Scoma","year":"1975","journal-title":"Arch Surg"},{"key":"2024093006455166800_bib26","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1007\/BF02586733","article-title":"Urinary retention following operations for benign anorectal diseases","volume":"21","author":"Prasad","year":"1978","journal-title":"Dis Colon Rectum"},{"key":"2024093006455166800_bib27","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1007\/s00384-005-0077-2","article-title":"Postoperative urinary retention after surgery for benign anorectal disease: potential risk factors and strategy for prevention","volume":"21","author":"Toyonaga","year":"2006","journal-title":"Int J Colorectal Dis"},{"key":"2024093006455166800_bib28","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1159\/000093554","article-title":"Acquired risk factors of venous thromboembolism in medical patients","volume":"35","author":"Prandoni","year":"2006","journal-title":"Pathophysiol Haemost Thromb"},{"key":"2024093006455166800_bib29","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1213\/01.ane.0000278089.16848.1e","article-title":"The effect of analgesic technique on postoperative patient-reported outcomes including analgesia: a systematic review","volume":"105","author":"Liu","year":"2007","journal-title":"Anesth Analg"},{"key":"2024093006455166800_bib30","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1097\/01.PRS.0000117303.63028.7D","article-title":"The outcome of abdominoplasty performed under conscious sedation: six-year experience in 153 consecutive cases","volume":"113","author":"Kryger","year":"2004","journal-title":"Plast Reconstr Surg"},{"key":"2024093006455166800_bib31","first-page":"96","article-title":"The public's fears about and perceptions of regional anaesthesia","volume":"29","author":"Matthey","year":"2004","journal-title":"Reg Anesth Pain Med"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.6792","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/97\/1\/12\/59443092\/bjs6792.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/97\/1\/12\/59443092\/bjs6792.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T06:53:25Z","timestamp":1727679205000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/97\/1\/12\/6148456"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,1,1]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2010,1,1]]},"published-print":{"date-parts":[[2010,1,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.6792","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2010,1]]},"published":{"date-parts":[[2010,1,1]]}}}