Ambulatory anorectal surgery under perianal anesthetics infiltration: Analysis of 222 cases

Abstract

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.