Ambulatory anorectal surgery under perianal anesthetics infiltration: analysis of 222 cases

To assess the safety and early postoperative results of ambulatory anorectal surgery using perianal anesthetics infiltration.

This retrospective study included 222 elective ambulatory anorectal surgical patients under perianal anesthetics infiltration between March 2002 and September 2005. Perioperative pain, postoperative complications, and surgical outcomes were analyzed.

The patients were 122 males and 100 females aged 16-84 (mean 43) years undergoing 150 closed hemorrhoidectomies, 55 lateral internal anal sphincterotomies, 28 fistulotomies, and 3 cauterizations for condyloma acuminata. Perianal block was effective, neither intravenous analgesics nor conversion to general anesthesia was needed. The average pain score was 3.4 +/- 2.3 on day 1 and 1.2 +/- 1.5 on day 7 postoperatively. Urinary retention was found in one case (0.5%). None of the patients needed hospital admission, except one emergency hospitalization (0.5%) due to bleeding.

Perianal anesthetics infiltration allows the surgeons to perform anorectal surgery in a day-case regimen safely and effectively with a low incidence of urinary retention.