Role of local anesthesia in pain relief post hemorrhoidectomy
Authors: Sahel Hammouri and Ala al Omari
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The aim of this study is to evaluate post-operative pain relief on patients who had hemorrhoidectomy. 300 patients who had hemorrhoidectomy were divided 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, total cost, hospital staying, operating time and post-operative period of time to start ambulation were measured and compared among the three groups. The study was performed during 2010 to 2014 in Jordanian Prince Rashid military hospital. The study showed that patients who had local anesthesia infiltration and sedation had significant influence decrease of post-operative total pain scores at 6/12/18/24 h more than 50%, (200/240/300/320) out of 1000 points compared to (420/500/540/580), (700/680/660/660) in the other 2 groups, the total post-operative analgesia doses in the 3 groups were (120, 140, 180) vials. The total hospital staying time for patients in each group were (130, 210, 260) days, while the total anesthesia and surgical and procedure time were (1500, 3000, 3500) min, total cost (25000, 30000, 35000) JD, post-operative lack of early ambulation time was (100/600/300) h, intra-operative doctor–patients interaction were(100/100/0) patients, headache (0, 8, 1) patients, urine retention (0.6.1) patients, nausea and vomiting (0, 1, 5) patients were reduced by 30%, (P-value < 0.05). In conclusion, post-operative pain, analgesia, total cost, hospital staying and operation time, intra-operative doctor–patients interaction, 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.
Keywords: Pain, local anesthesia, analgesia, complications, hemorrhoidectomy.