Anorectal Surgeries under Local Anesthesia: A Single Center Experience
Introduction: Surgeries done under local anesthesia are associated with fewer perioperative risks and postoperative complications compared to general or spinal anesthesia. This study was contemplated to test the feasibility and efficacy of local anesthesia in anorectal surgeries. Materials and methods: This study was done in the Department of Surgery, Dayanand Medical College & Hospital, Ludhiana, Punjab, India. A total of 50 patients presenting with anorectal problems, aged more than 16 years and qualifying for grades I and II of American Society of Anesthesia classification, were selected for the study, after informed consent. A cocktail of bupivacaine hydrochloride 0.5%, lidocaine 2%, sodium bicar­ bonate and adrenaline, was injected around the perianal skin. Intraoperative parameters, such as blood pressure, pulse, respiratory rate, and intensity of pain were recorded in all the patients. Each patient was closely monitored postoperatively for timing and frequency of analgesic dose, need for bladder catheterization, immediate and delayed complications, time needed for patient to be ambulant and length of hospital stay. Results: The duration of procedures was 19 ± 6 (mean ± stan­ dard deviation) minutes. Patients required analgesic dose after 4.25 ± 1.14 hours, with almost half (48%) requiring it after 6 hours. Majority of patients (82%) were ambulatory within the 1st hour with a meantime of 50 ± 13 minutes. Three cases had complicated postoperative course, with perianal infection and fissure formation. Conclusion: Local anesthesia is effective and safe for anorectal surgeries, reducing recuperating time and allowing early ambu­ lation. Such day care procedures, requiring lesser monitoring, can emerge as a preferred technique in low­resource settings, considering their cost­effectiveness.