Comparison of Two Methods: Spinal Anesthesia and Ischiorectal Block on Post Hemorrhoidectomy Pain and Hospital Stay: A Randomized Control Trial

ABSTRACT

Objective: Hemorrhoidectomy is one of the most common hemorrhoid surgery. Many areas are innervated by nerves, and this makes the surgery to be very painful. Various anesthetic methods have been proposed, and the number of investigations and procedures demonstrated the absence of a reliable method for reducing pain. This study compares the cavity ischiorectal block with spinal anesthesia in reducing postoperative pain, analgesic consumption, and hospital stay. Research design: This study is a randomized control trial carried out on seventy patients sampled. Thirty-five (35) among them were placed in spinal anesthesia group, and the other 35 were placed in the ischiorectal block group. According to the study, questionnaire was designed in such a way that postoperative variables such as postoperative pain, analgesic consumption, changes in blood pressure, heart rate and hospital stay in both groups were evaluated and compared. Clinical trial registration: IRCT2015111616516N3 (http://en.search.irct.ir/search?query=IRCT2015111616516N3) Results: In this study, the pain scores on Visual Analogue Scale (VAS) at 0, 6, 12, and 24 hr for spinal anesthesia group after surgery were 0, 3.08 ± 0.78, 2.05 ± 1.02, 1.11 ± 0.83, respectively (p < 0.05). That of ischiorectal blocks were 0.98 ± 0.25, 1.57 ± 0.81, 0.91 ± 0.91, and 0.63 ± 0.31 respectively, which indicated lesser pain after surgery in the ischiorectal block at 6, 12, and 24 hr. In this study, out of the 35 patients that underwent spinal anesthesia, 28 patients (80%) were hospitalized in the first 6 hr, 13 patients (37.1%) in the second 6 hr, 3 patients (8.6%) in the second 12 hr after surgery. For patients under the ischiorectal block, the number of patients hospitalized were 13 patients (37.1%), in the first 6 hr, 4 patients (11.4%) in the second 6 hr, and 1 (2.9%) were hospitalized in the second 12 hr after surgery (p < 0.05). Conclusion: Ischiorectal blocks causes less pain, require fewer painkillers, and reduces the hospital stay after surgery than spinal anesthesia.

Keywords::

• hemorrhoidectomy
• ischiorectal block
• spinal anesthesia
• pain

ACKNOWLEDGMENTS

The researchers of the study express their gratitude to the Department of Anesthesiology, Lorestan University of Medical Sciences, Khorramabad, Iran and Department of Surgery, Lorestan University of Medical Sciences, Khorramabad, Iran.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

FUNDING DETAILS

This work was supported by Lorestan Universitiy of Medical Sciences.

Ethical Approval

All procedures performed in these studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration, and its amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.