Ambulatory Anorectal Surgery under Perianal Anesthetics Infiltration: Analysis of 222 Cases
Varut Lohsiriwat MD*, Darin Lohsiriwat MD*
Affiliation : * Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
Objective : To assess the safety and early postoperative results of ambulatory anorectal surgery using perianal
anesthetics infiltration.
Materials and Methods : This retrospective study included 222 elective ambulatory anorectal surgical patients
under perianal anesthetics infiltration between March 2002 and September 2005. Perioperative pain, post-
operative 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.
Keywords : Ambulatory surgery, Anorectal disease, Perianal anesthetics infiltration
