Study interventions:
The patients will be randomized into two equal groups, Group A and Group B.
Group A: Patients will receive an Ultrasound guided sacral erector spinae plane block (SESPB)
Group B: Patients will receive Saddle block.
The surgical procedure will be performed by an experienced surgeon.
The outcome:
The primary outcome will be assessment of pain intensity using the NRS ranging from 0 (no pain) to 10 (worst pain) at 0, 2, 4, 6, 12, and 24 hours after the procedure. The secondary outcomes will include the cumulative doses of tramadol (50 mg intramuscular) to be repeated every 8 hours in case NRS score is more than four, the number of patients requiring rescue medication in the postoperative period.
Patients with American Society of anesthesiologists' physical status (ASA) I to II.
Aged 18 to 65 years.
Both sexes.
Patients scheduled for perianal surgeries (hemorrhoidectomy).
1- Patients with spinal malformation. 2-Patients with liver impairment. 3- Patients with renal impairment. 4-Patients younger than 18 years or older than 65 years. 5- Patients with hypersensitivity to one of the used drugs. 6- Coagulopathy disorders. 7- Patients who underwent hemorrhoidectomy before.