Post Hemorrhoidectomy Pain Relief; Outcome of Local Anesthesia

Abstract

The aim of my study is to evaluate post-operative pain relief on patients who had hemorrhoidectomy. Materials and Methods: 300 patients who had hemorrhoidectomy were divided equally in to three groups, according to anesthesia type, group 1 (local anesthesia and sedation), while spinal anesthesia was group 2 and general anesthesia was considered to be group 3. Pain relief, post-operative complications, hospital staying time were measured and compared between the three groups. Period: Study was performed between Jan 2012 to Dec 2014. Results: The study showed that patients who had local anesthesia infiltration and sedation a significant decrease of post-operative total pain scores at 6/12/18/24 hours of more than 50%,200/240/300/320 out of 1000 points in group II as compared to 420/500/540/580,700/680/660/660 in 3rd groups respectively. The total postoperative analgesia doses in the 3 groups were 120:140:180 respectively, total hospital staying time were 130:210:260 days, headache in the ratio of 0:8:1, urine retention in 0:6:1 patients, nausea and vomiting in 0:1:5 patients were reduced by 30 %,. P-value < 0.05. On the other hand, spinal anesthesia which is group 2 showed slight decline of patients numbers who had respiratory symptoms, hypotension and urticarial.Conclusion: Post-operative pain, analgesia, total cost, hospital staying time, nausea and vomiting have been significantly reduced by local anesthesia infiltration compared to non-infiltrated groups while spinal anesthesia had a higher rate in post-operative urine retention, headache and hypotension compared to local anesthesia with sedation and general anesthesia. Respiratory symptoms, urticaria, were slightly reduced in local anesthesia with sedation compared to spinal and general anesthesia.

Ultrasound-Guided Pudendal Nerve Block Combined with Propofol Deep Sedation versus Spinal Anesthesia for Hemorrhoidectomy: A Prospective Randomized Study

“…Our pilot study and a previous study [ 18 ] showed that the mean pain VAS score at 12 h was 5 (standard deviation [SD]: 3.5) in patients with hemorrhoidectomy under the spinal anesthesia. Utilizing α = 80% and β = 0.05, a 2-tailed analysis showed that we needed 49 patients/group for a reduction in pain intensity by 40% in the case of patients with hemorrhoidectomy under PNB with deep sedation.…”