{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:34:22Z","timestamp":1789518862586,"version":"build-2803163510"},"reference-count":31,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Scientific World Journal"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p><jats:italic>Background and Objective<\/jats:italic>. This study aimed to compare the effects of different local anesthetic solutions on postoperative pain of anal surgery in adult patients.<jats:italic>Method<\/jats:italic>. In this randomized double-blind prospective clinical trial, 60 adult patients (18 to 60 years old) with physical status class I and class II that had been brought to a university hospital operating room for fistula anal surgery with spinal anesthesia were selected. Patients were randomly divided into 4 equal groups according to table of random numbers (created by Random Allocation Software 1). Group 1 received 3\u2009mL of normal saline, group 2, 1\u2009mL of normal saline plus 2\u2009mL of bupivacaine 0.5%, group 3, 1\u2009mL of ketamine plus 2\u2009mL of bupivacaine 0.5%, and group 4, no infiltration. Intensity of pain in patients was measured using visual analogue scale (VAS) at 0 (transfer to ward), 2, 6, 12, and 24 hours after surgery. Time interval to administration of drugs and overall dose of drugs were measured in 4 groups.<jats:italic>Results<\/jats:italic>. Mean level of pain was the lowest in group 3 at all occasions with a significant difference, followed by groups 2, 4, and lastly 1 (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:math>). Furthermore, groups 2 and 3 compared to groups 1 and 4 had the least overall dose of analgesics and requested them the latest, with a significant difference (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.05<\/mml:mn><\/mml:math>).<jats:italic>Conclusion<\/jats:italic>. Local anesthesia (1\u2009mL of ketamine plus 2\u2009mL of bupivacaine 0.5% or 1\u2009mL of normal saline plus 2\u2009mL of bupivacaine 0.5%) combined with spinal anesthesia reduces postoperative pain and leads to greater comfort in recovering patients.<\/jats:p>","DOI":"10.1155\/2014\/424152","type":"journal-article","created":{"date-parts":[[2014,12,3]],"date-time":"2014-12-03T21:01:35Z","timestamp":1417640495000},"page":"1-6","source":"Crossref","is-referenced-by-count":7,"title":["The Effect of Local Injections of Bupivacaine Plus Ketamine, Bupivacaine Alone, and Placebo on Reducing Postoperative Anal Fistula Pain: A Randomized Clinical Trial"],"prefix":"10.1155","volume":"2014","author":[{"given":"Alireza","family":"Kazemeini","sequence":"first","affiliation":[{"name":"Department of General Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, 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