A Comparative Analysis on Regional Verses Local Anaesthesia in Hemorrhoidectomy Cases

  • Devendra Singh Assistant Professor, Department of Anaesthesia, Rohilkhand Medical College Bareilly.
  • Vinod Rathore Assistant Professor, Department of Anaesthesia, Rohilkhand Medical College Bareilly.
Keywords: Hemorrhoidectomy, anorectal condition, defecation

Abstract

Background: Haemorrhoidal disease is a common anorectal condition. It is classified as external or internal. It also depends on their origin, i.e. below or above the dentate line and both of which can coexist. Its etiology includes low residue diet, straining at defecation, constricting cancer, portal hypertension, aging and weakness of muscle supporting veins, constipation, prostatism, sitting or standing for long periods of time, obesity, the lifting of heavy weights over a long period, repeated diarrhea and dysentery and the tendency to suppress the urge to defaecate or flatulate

Methods: In this comparative study we were included 60 cases, which were split in local anesthesia group & spinal anesthesia group. This study was conducted in Department of Anesthesia.

Results: In our study 60 total numbers of cases were included. We observed Median pain score in this study that was in 0 cases at 30 min, in 3 cases at 2 hours,3 cases at 4 hours, in 2 cases at 8 hours & in 0 cases at 12 hours in both groups.

Conclusions: This study concludes that Hemorrhoidectomy can be done in local anesthesia with perianal block. Though, this method of anesthesia is associated with lower postoperative complication. Post-operative pain is similar to spinal anesthesia.

Downloads

Download data is not yet available.

References

Thompson WHF. The nature of hemorrhoids. Br J Surg 1975; 62:542–52CrossRefGoogle Scholar

Loder PB, Kamm MA, Nichells RJ, et al. Hemorrhoids pathology, pathophysiology and aetiology. Br J Surg 1994; 1:946–54CrossRefGoogle Scholar

Pienninger JL, Surrell J. Non surgical treatment options for internal hemorrhoids. Am Fam Physician 1995; 52:821–34Google Scholar

Godeberge P. Daflon 500mg in the treatment ofhemorrhoidal disease: a demonstrated efficacy in comparison with placebo. Angiology 1994; 45:574–8PubMedGoogle Scholar

Steele RJG, Campbell K. Disorders of the anal canal: Haemorrhoids. Essential Surgical Practice; 4th edition: London, Arnold 2002; pp.627–45Google Scholar

Manzoor Ali, Zahid Ahmad Hashmi, Adnan Zafar. Swat, Haemorrhoidectomy using pudendal nerve, block and local infiltration. Gomal Journal of Medical Sciences 2010; 8:185–9Google Scholar

Abramowitz L, Godeberge P, Staumont G, et al. Clinical practice guidelines for the treatment of hemorrhoidal disease [in French]. Gastroenterol Clin Biol 2001; 25:674–702PubMedGoogle Scholar

Hulme-Moir M, Bartolo DC. Hemorrhoids. Gastroenterol Clin North Am 2001; 30:183–97CrossRefPubMedGoogle Scholar

Morgado PJ, Suárez JA, Gómez LG, et al. Histoclinical basis for a new classification of hemorrhoidal disease. Dis Colon Rectum. 1988; 31:474–80CrossRefPubMedGoogle Scholar

Aigner F, Gruber H, Conrad F, et al. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease. Int J Colorectal Dis 2009; 24:105–13CrossRefPubMedGoogle Scholar

Chung YC, Hou YC, Pan AC. Endoglin (CD105) expression in the development of haemorrhoids. Eur J Clin Invest 2004; 34:107–12CrossRefPubMedGoogle Scholar

Goenka MK, Kochhar R, Nagi B, et al. Rectosigmoid varices and other mucogal changes in patients with portal hypertension. Am J GAstroenterol. 1991; 86:1185–9.PubMedGoogle Scholar

Han W, Wang ZJ, Zhao B, et al. Pathologic change of elastic fibers with difference of microvessel density and expression of angiogenesis-related proteins in internal hemorrhoid tissues. Zhonghua Weichang Waike Zazhi 2005; 8:56–9PubMedGoogle Scholar

Yoon SO, Park SJ, Yun CH, et al. Roles of matrix metalloproteinases in tumor metastasis and angiogenesis. J Biochem Mol Biol 2003; 36:128–37

Luck AJ and Hewett PJ (2000): Ischiorectal fossa block decreases posthemorrhoidectomy pain: randomized, prospective, double-blind clinical trial. Dis Colon Rectum; 43:142-5.

Delikoukos S and Gikas D (2007): The role of local anesthesia in ambulatory anal surgery. Ambulatory surgery 133; 64-66.

Ho KS, Eu KW, Heah SM, Seow- Choen F and Chan YW (2000): Randomized clinical trial of hemorrhoidectomy under a mixture of local anesthesia versus general anesthesia. British J Surg. 87: 410-413.

Park SJ, Choi SI, Lee SH and Lee KY (2010): Local perianal block in anal surgery: The disadvantage of pain during Injection despite high patient satisfaction. J Korean Surg Soc; 78:106-110.

Davies RJ . Haemorrhoids. Clinical evidence. 2006; 15:1–2.

Dennison AR, Wherry DC, Morris DL. Haemorrhoids. Nonoperative management. The Surgical Clinics of North America. 1988; 68:1401-1409

R. Kushwaha, W. Hutchings, C. Davies and N. G. Rao. Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia. British Journal of Surgery 2008; 95: 555–563

Argov S, Levandovsky O. Radical, ambulatory hemorrhoidectomy under local anesthesia. Am J Surg 2001; 182: 69–72.

Lacerda-Filho A, Cunha-Melo JR. Outpatient haemorrhoidectomy under local anaesthesia. Eur J Surg 1997; 163: 935–940.

Haveran LA, Sturrock PR, Sun MY, McDade J, Singla S, Paterson CA, et al. Simple harmonic scalpel hemorrhoidectomy utilizing local anesthesia combined with intravenous sedation: a safe and rapid alternative to conventional hemorrhoidectomy. Int J Colorectal Dis 2007; 22: 801-6.

Lohsiriwat D, Lohsiriwat V. Outpatient hemorrhoidectomy under perianal anesthetics infiltration. J Med Assoc Thai 2005; 88: 1821-4.

Argov S. Ambulatory radical hemorrhoidectomy: personal experience with 1,530 Milligan-Morgan operations with follow-up of 2-15 years. Dig Surg 1999; 16: 375-8.

Kona V. Conditions and diseases of digestive system, 2010. available at: http/:www. OmniMedicalsearch.com.

Nivatvongs S. Technique of local anesthesia for anorectal surgery. Dis Colon Rectum 1997; 40: 1128-9

Delikoukos S, Zacharoulis D, Hatzitheofilou C. Stapled hemorrhoidectomy under local anesthesia: tips and tricks. Dis Colon Rectum 2005; 48:2153-5.

G. G. Ravindranath, B. G. Rahul. Prevalence and risk factors of hemorrhoids: a study in a semi-urban centre.International Surgery Journal ;February 2018 : Vol 5 ; Issue 2 Page 496

Published
2019-12-24
How to Cite
1.
Singh D, Rathore V. A Comparative Analysis on Regional Verses Local Anaesthesia in Hemorrhoidectomy Cases. Int Arch BioMed Clin Res [Internet]. 2019Dec.24 [cited 2020Apr.9];5(4):AN1-AN3. Available from: https://www.iabcr.org/index.php/iabcr/article/view/550
Section
ORIGINAL ARTICLES ~ Anaesthesiology