Comparison of the Surgical Results of Hemorrhoidectomy under Intravenous General Anesthesia and Spinal Anesthesia

Abstract

Background. The purpose of this study is to evaluate the pros and cons of the two common anesthetic methods used for hemorrhoidectomy. Methods. We prospectively collected a database of 81 consecutive patients whose symptomatic hemorrhoids were managed by LigaSure hemorrhoidectomy at our hospital. Among these patients, 40 received intravenous general anesthesia with perianal anesthetic infiltration (group 1) and 41 patients received spinal anesthesia (group 2). The groups were compared with respect to demographic data, operative time, total time in the operating room, postoperative pain score, narcotic consumption, complications, length of hospital stay, operative outcomes, and satisfaction level. Results. All patients tolerated the whole course of the operation in the prone jackknife position without anesthetic or anesthetic-associated complications. There was no significant difference between the groups with respect to patient age, gender, ASA grade, preoperative hemoglobin level, operative time, duration of hospital stay, pain score of the first postoperative day, postoperative narcotic consumption, early or late complications, duration of follow-up, and patient satisfaction level. However, the mean time spent in the operating room was significant longer in group 2 than in group 1 (45.5 vs. 60.1 min, respectively, p ＜ 0.05). At the completion of follow-up, all patients in both groups were fully continent and no instances of anal stricture or recurrent symptoms occurred. Conclusion. Both anesthetic methods are safe and effective for hemorrhoidectomy without significant difference in operative outcomes, analgesic requirements, complications, and patient satisfaction. However, spinal anesthesia is associated with a longer time in the operating room.