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Abstract: Ambulatory anorectal surgery under perianal anesthetics infiltration: analysis of 222 cases.


Lohsiriwat V, Lohsiriwat D.


Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.


J Med Assoc Thai. 2007 Feb;90(2):278-81.


OBJECTIVE: To assess the safety and early postoperative results of ambulatory anorectal surgery using perianal anesthetics infiltration. MATERIAL AND METHOD: This retrospective study included 222 elective ambulatory anorectal surgical patients under perianal anesthetics infiltration between March 2002 and September 2005. Perioperative pain, postoperative complications, and surgical outcomes were analyzed. RESULTS: The patients were 122 males and 100 females aged 16-84 (mean 43) years undergoing 150 closed hemorrhoidectomies, 55 lateral internal anal sphincterotomies, 28 fistulotomies, and 3 cauterizations for condyloma acuminata. Perianal block was effective, neither intravenous analgesics nor conversion to general anesthesia was needed. The average pain score was 3.4 +/- 2.3 on day 1 and 1.2 +/- 1.5 on day 7 postoperatively. Urinary retention was found in one case (0.5%). None of the patients needed hospital admission, except one emergency hospitalization (0.5%) due to bleeding. CONCLUSION: Perianal anesthetics infiltration allows the surgeons to perform anorectal surgery in a day-case regimen safely and effectively with a low incidence of urinary retention.


General Surgery Haemorrhoidectomy Sphincterotomy Anal Fistula