Pain relief after haemorrhoidectomy; evaluation of a new simple technique

ABSTRACT

This study included 120 patients with 2nd, 3rd, or 4th degree piles. They were divided into 4 equal groups A, B, C and D. Hemorrhoidectomy by excision and ligation was done for all of them, and for groups C and D internal sphincterotomy was also done. Intermitent perfusion of the anal canal with bupivacaine 0.5% was done for groups B and D after the operation. Postoperative pain was assessed according to the amount of analgesics needed by the patients. It was found that analgesic requirment was more or less similar in groups B and C, while it was significantly less in each of them compared to group A [P <0.01]. The reduction of analgesia was highly significant in group D compared to group A [P <0.001]. Postoperative retention of urine was found to be significantly less in group D than in group A which reflects the marked relief of pain offered to the patients by doing internal sphincterotomy together with perfusion of the ana canal with bupivacaine. So, it was recommended that the addition of these two procedures to the classical hemorrhoidectomy in order to reduce the posthemorrhoiectomy pain