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Comparison of Postoperative Results after Hemorrhoidectomy Using Local and Spinal Anesthesia
Summary
Hemorrhoidectomy using local anesthesia (LA) on an outpatient basis is safe and feasible. While initial pain is higher with LA, it decreases significantly within 24 hours compared to spinal anesthesia (SA).
Area of Science:
- Colorectal Surgery
- Anesthesiology
- Surgical Outcomes
Background:
- Hemorrhoidectomy is a common surgical procedure.
- Typically performed inpatient under general or regional anesthesia.
- Limited use of local anesthesia due to postoperative care concerns.
Purpose of the Study:
- Compare perioperative outcomes of hemorrhoidectomy.
- Evaluate local anesthesia (LA) outpatient vs. spinal anesthesia (SA) inpatient.
- Assess pain, urinary retention, bleeding, and complications.
Main Methods:
- Retrospective study of closed hemorrhoidectomy for grade 3 hemorrhoids.
- Comparison between local anesthesia (LA) and spinal anesthesia (SA) groups.
- 91 patients recruited between March 2011 and March 2014.
Main Results:
- Early complications were similar between LA and SA groups.
- LA group reported higher initial postoperative pain (VAS 8.8 vs. 5.3 at 6 hours, p<0.001).
- LA group reported lower postoperative pain at 24 hours (VAS 6.5 vs. 7.29, p=0.002).
Conclusions:
- Hemorrhoidectomy under local anesthesia is safe and feasible for outpatient procedures.
- Proper patient counseling and consent are crucial for LA outpatient hemorrhoidectomy.
- LA offers a viable alternative to inpatient SA for selected hemorrhoidectomy cases.
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