Local Versus General Anaesthesia in Stapled Hemorrhoidectomy

Local vs General Anaesthesia in Stapled Hemorrhoidectomy: A Multicentric Controlled Randomized Trial

The purpose of this study is to determine whether local or general anaesthesia in stapled hemorrhoidectomy leads to a shorter operation time with a better patient comfort.

Hemorrhoids are a frequent disease with the need of surgical intervention in 10-20% of the patients. The stapled hemorrhoidectomy according to Longo under general anesthesia (or spinal) is considered standard of care [1]. Cohort studies show that a pudendal bloc with local anesthesia is safe and efficient [2-4]. The majority of procedures are actually performed in private clinics or in an ambulatory setting underlining the importance of economic issues such as procedure time (anesthesia and operation time) and hospital stay.

We hypothesize that stapled hemorrhoidectomy under local anaesthesia shortens anaesthesia time and hospital stay and reduces costs with no disadvantages regarding pain, satisfaction and complication rate.

Inclusion Criteria:

• Hemorrhoids grade III suitable for elective stapled hemorrhoidectomy

Exclusion Criteria:

• Age < 18 years
• No informed consent
• Emergency situation
• Contraindication to either anaesthesia method
• Patients not speaking french or german.
• Additional anal pathology (fissure, tumour).