Comparison of postoperative results after hemorrhoidectomy under local and spinal anesthesia

Q2 Nursing

Perioperative Care and Operating Room Management Pub Date : 2024-06-01 DOI:10.1016/j.pcorm.2024.100402

Nguyen Trung Vo , Viet Tung Le , Quoc Vinh Nguyen , Tan Thanh Nguyen , Manh Tuan Ha

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引用次数: 0

Abstract

Background

Hemorrhoidectomy is commonly performed under general or regional anesthesia; nevertheless, the underutilization of local anesthesia is attributed to safety concerns. The aim of this study was to compare postoperative outcomes following hemorrhoidectomy using local anesthesia and spinal anesthesia.

Methods

This study was a retrospective cohort study, conducted at the General Surgery Department of the University Medical Center Ho Chi Minh City Branch 2 from January 2018 to September 2023, focused on Milligan-Morgan hemorrhoidectomies for third or fourth-degree hemorrhoids.

Results

A total of 114 patients with third or fourth-degree hemorrhoids were included in the study, with 59 patients in the local anesthesia group and 55 patients in the spinal anesthesia group. Throughout all three time points, average pain scores were consistently lower in the local anesthesia group. The average recovery time for the local anesthesia group was 8.34 ± 6.17 days, and for the spinal anesthesia group, it was 10.50 ± 7.01 days. However, these differences were not statistically significant (p > 0.05). Notably, the local anesthesia group exhibited a significantly lower rate of postoperative complications compared to the spinal anesthesia group (0 % versus 5.5 %, respectively). Additionally, the local anesthesia group had a significantly shorter length of stay (11.07 ± 15.81 h) and lower medical costs (7,793,187 ± 1,835,713 VND) compared to the spinal anesthesia group (32.87 ± 26.06 h and 9,468,098 ± 2,883,630 VND, respectively).

Conclusions

Hemorrhoidectomy under local anesthesia is feasible and safe, and local anesthesia may be considered as an alternative to spinal anesthesia in some cases.

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局部麻醉和脊髓麻醉下痔疮切除术的术后效果比较

背景痔疮切除术通常在全身麻醉或区域麻醉下进行；然而，由于安全问题，局部麻醉的使用率较低。本研究的目的是比较使用局部麻醉和脊髓麻醉进行痔切除术后的结果。方法本研究是一项回顾性队列研究，于2018年1月至2023年9月在胡志明市大学医学中心第二分部普外科进行，主要针对三度或四度痔的米利根-摩根痔切除术。结果共有114名三度或四度痔疮患者被纳入研究，其中局麻组59人，椎管内麻醉组55人。在所有三个时间点中，局部麻醉组的平均疼痛评分一直较低。局部麻醉组的平均恢复时间为 8.34 ± 6.17 天，脊髓麻醉组为 10.50 ± 7.01 天。然而，这些差异并无统计学意义（p > 0.05）。值得注意的是，与脊髓麻醉组相比，局部麻醉组的术后并发症发生率明显较低（分别为 0 % 对 5.5 %）。此外，与脊髓麻醉组相比，局部麻醉组的住院时间（11.07±15.81 h）和医疗费用（7,793,187±1,835,713 越南盾）都明显更短（32.87±26.06 h 和 9,468,713越南盾）。结论局部麻醉下进行痔切除术是可行和安全的，在某些情况下，局部麻醉可被视为脊髓麻醉的替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

56 days

期刊介绍： The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.