• R Gerjy, A Lindhoff-Larson, R Sjödahl, and P-O Nyström.
• Colorectal Surgery, Department of Surgery, Linköping University Hospital, Linköping, Sweden. roger.gerjy@lio.se
• Br J Surg. 2008 Nov 1;95(11):1344-51.

BackgroundThe aim was to assess the feasibility of performing stapled haemorrhoidopexy under local anaesthesia.MethodsFifty-eight patients with haemorrhoid prolapse were randomized to receive local or general anaesthesia. The perianal block was applied immediately peripheral to the external sphincter. Submucosal block was added after applying the purse-string suture. Patients reported average and peak pain daily for 14 days using a visual analogue scale (VAS). They also completed anal symptom questionnaires before the operation and at follow-up. The surgeon assessed the restoration of the anal anatomy 3-6 months after surgery.ResultsThe anal block was sufficient in all patients. The mean accumulated VAS score for average pain was 23.1 in the general anaesthesia group and 29.4 in the local anaesthesia group (P = 0.376); mean peak pain scores were 42.1 and 47.9 respectively (P = 0.537). Mean change in symptom load was also similar between the groups, with score differences of 7.0 in the general anaesthesia group and 6.1 in the local anaesthesia group. No patient had a recurrence of prolapse.ConclusionPerianal local block is easy to apply with a high degree of acceptability among patients. Postoperative pain, restoration of anatomy and symptom resolution were similar to that of stapled haemorrhoidopexy performed under general anaesthesia.Registration NumberISRCTN19930199 (http://www.controlled-trials.com).Copyright (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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