Techniques in Coloproctology (2018) 22:465–466 https://doi.org/10.1007/s10151-018-1801-6 TRICK OF THE TR ADE 1 2 1 1 V. Bolshinsky · B. Gurland · T. L. Hull · M. Zutshi Received: 3 May 2018 / Accepted: 15 May 2018 / Published online: 31 May 2018 © Springer International Publishing AG, part of Springer Nature 2018 Levator spasm is a condition characterized by constant or The procedure is performed in a lithotomy position under frequent anal pain that is typically dull in nature. This is general, or monitored anesthesia care (MAC) anesthesia. due either to paradoxical contraction of the puborectalis at The patient is prepped and draped in the standard fashion. the anorectal junction during defecation, or the failure of We commence the procedure by performing a pudendal muscular relaxation . Symptoms typically occur more nerve block, injecting 5 ml of local anaesthetic near each than 6 months prior to diagnosis, with episodes lasting for ischial tuberosity and 10 ml into the levators via the trans- longer than 20 min at a time, on a background of persistent perineal route. The use of local anaesthetic blockade is syn- rectal pain. The pain is reproduced by posterior palpation ergistic in the relief of symptoms, as there is a delay of 1 of the puborectalis
Techniques in Coloproctology – Springer Journals
Published: May 31, 2018
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