Haemorrhoidectomy using Pudendal Nerve Block and Local Infiltration

Abstract

Background: Haemorrhoidal disease is a common anorectal condition. The aim of this study was to evaluate the results of pudendal nerve block for conventional open haemorrhoidectomy and compare the results with general anaesthesia. Methodology: It was a descriptive study carried out in the Department of Surgery Saidu Teaching Hospital, Shah Medical Surgical Hospital and New Modern Surgical Hospital, Swat, from January 2005 to December 2008. Pre and postoperative data of 243 patients, age range 28-68 years, was analyzed to establish the effectiveness of pudendal anaesthesia with local infiltration of piles. Patients were divided into two groups. Group-I included 122 patients operated with pudendal nerve block local infiltration anaesthesia and Group-II included 121 patients operated under general anaesthesia. Results: Postoperative symptoms like pain, heaviness, bleeding, constipation, prolapse, mean operating time, duration of hospital stay, return to normal working activities and 6 months evaluation were compared between the two groups. Results of Group-I were better than Group-II. Conclusion: Pudendal nerve block anaesthesia with local infiltration of skin and subcutaneous tissue is effective in performing open haemorrhoidectomy. This can be used as alternative anaesthesia in patients who are unwilling or unfit for other forms of anaesthesia.