SPECIFIC ASPECTS OF ANESTHESIA IN PROCTOLOGY

Proctology, as a domain of abdominal surgery, deals with the treatment of diseases affecting the end part of the large bowel, it’s terminal 20 cm, to which anus anatomically belongs as well. In view of the physiological role of this part of the digestive tract (stool control), all the diseases and disorders in the region cause patient discomfort and produce significant problems in everyday life. On account of that, diagnostic management should be performed promptly in order that effective treatments could be introduced as soon as possible. The most commonly used techniques of anesthesia in proctology are local anesthesia, independent or in combination with intravenous analgosedation, regional anesthesia (spinal and epidural), and general anesthesia. Local anesthesia combined with analgosedation has been the preferred approach in recent studies, since it is able to provide adequate settings for the planned surgery, patient comfort and minimization of side effects. An adequate anesthesia technique reduces metabolic response to surgical stress and length of hospitalization, which markedly affects cost-effectiveness of the treatment.