Comparative study of stapled haemorrhoidectomy under local anaesthesia versus spinal anaesthesia
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Hellenic Journal of Surgery (2016) 88:2, 85-92
Comparative Study of Stapled Haemorrhoidectomy Under Local Anaesthesia Versus Spinal Anaesthesia Naveen Kumar, Neeti Kapur
Abstract Background: The aim of this study is to compare and evaluate the results of stapled haemorrhoidectomy performed
under local anaesthesia against those performed under spinal anaesthesia in terms of postoperative pain, bleeding per rectum, the time needed for return to normal bowel habits and resumption of normal physical activities (within one week of surgery), incidence of recurrence and stenosis (within three months of surgery). Methodology: An open, prospective, single centre randomized controlled trial was conducted at PGIMER, DR. RML Hospital, New Delhi for a period of 15 months w.e.f. 01.11.2011. The study included 50 patients over the age of eighteen years, with bleeding per rectum and grades 3 and 4 haemorrhoids, who were randomized to either local or spinal anaesthesia. Group I included study subjects who had undergone stapler haemorrhoidectomy under local anaesthesia and group II comprised those submitted to the same procedure under spinal anaesthesia. Results: A significant difference in duration of hospital stay post surgery was noted between the two groups. Those
undergoing the procedure under local anaesthesia were discharged far sooner than those receiving spinal anaesthesia. It was also found that the immediate postoperative complications, namely headache and retention of urine, were common among group II patients whereas none of the patients in group I reported similar complaints. Otherwise, there was little significant difference between the two groups in terms of pain scores, postoperative bleeding per rectum, and the time required for the return of normal bowel habits and resumption of normal physical activities Conclusion: Stapler haemorrhoidectomy under pudendal block with local skin and subcutaneous anaesthesia is a
feasible and effective treatment modality. Key words: Haemorrhoids; stapled haemorrhoidectomy; local anaesthesia; spinal anaesthesia
Introduction Haemorrhoidal disease is a common anorectal condition classified as external or internal depending on their origin, i.e. below or above the dentate line, both of which can coexist. Its aetiology includes straining at defaecation, low residue diet, sphincter damage, pregnancy, constricting cancer, portal hypertension, aging and weakness of muscle supporting veins, constipation, prostatism, sitting or standing for long periods of time, hereditary predis-
Naveen Kumar M.S. (General Surgery), Senior Resident, PGIMER, Dr.R.M.L Hospital, New Delhi Neeti Kapur M.S. (General Surgery), Senior Surgeon & Associate Professor, PGIMER, Dr.R.M.L Hospital, New Delhi Corresponding authors: Naveen Kumar M.S. (General Surgery), Senior Resident, PGIMER, Dr.R.M.L Hospital, New Delhi Tel.: 09968262759, e-mail: [email protected] Neeti Kapur M.S. (General Surgery), Senior Surgeon & Associate Professor, PGIMER, Dr.R.M.L Hospital, New Delhi Tel.: 09818182212, e-mail: neetikapu
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