■痔疮切除术后的术后疼痛和并发症构成了重大挑战。以最小的并发症获得有效的麻醉是至关重要的。非卧床痔切除术的理想麻醉方法仍不确定。这项研究旨在调查在痔疮切除术中,与脊髓麻醉(SA)相比,全身麻醉加局部浸润(GAL)的组合是否具有较低的并发症和减轻的疼痛。
■这项回顾性单中心队列研究,在东亚的三级医疗中心进行,评估了2017年1月1日至2023年3月31日期间使用GAL或SA进行的痔疮切除术.关于六种最常见并发症——疼痛的数据,便秘,急性尿潴留(AUR),出血,恶心,和头痛-从医疗记录中提取。总共包括550例痔疮切除术:GAL组220例,SA组330例。两组患者特征具有可比性。
■与SA组相比,GAL组的AUR率显着降低(15.5%vs.32.1%,P<0.001)。尽管GAL和SA组之间疼痛评分≥4的比例没有显着差异(36.2%vs.39.8%,P=0.429),疼痛评分曲线呈稳定趋势.总的来说,GAL组的不良反应发生率较低(56.9%vs.67.4%,P=0.023)。GAL组和SA组之间的其他并发症和急诊再入院率没有显着差异。
■GAL成为痔疮切除术麻醉的有利选择,在多发性痔切除术中,尿潴留的发生率较低,镇痛效果延长。这些发现支持以下结论:GAL是增强痔疮切除术患者术后体验的最佳麻醉方法。
UNASSIGNED: Postoperative pain and complications pose significant challenges following a hemorrhoidectomy. Attaining effective anesthesia with minimal complications is crucial. The ideal anesthesia method for ambulatory hemorrhoidectomy remains uncertain. This study aimed to investigate whether the combination of general anesthesia plus local infiltration (GAL) is associated with lower complications and reduced pain compared to spinal anesthesia (SA) in the context of hemorrhoidectomy.
UNASSIGNED: This retrospective single-center cohort study, conducted in a tertiary medical center in East Asia, evaluated excisional hemorrhoidectomies performed between January 1, 2017, and March 31, 2023, utilizing GAL or SA. Data on the six most common complications-pain, constipation, acute urine retention (AUR), bleeding, nausea, and headache-were extracted from medical records. A total of 550 hemorrhoidectomies were included: 220 in the GAL group and 330 in the SA group. Patient characteristics were comparable between the two groups.
UNASSIGNED: The AUR rate was significantly lower in the GAL group compared to the SA group (15.5% vs. 32.1%, P < 0.001). Although the proportion of pain scores ≥4 did not differ significantly between the GAL and SA groups (36.2% vs. 39.8%, P = 0.429), the pain score curve indicated a stable trend. Overall, the GAL group exhibited a lower rate of adverse effects (56.9% vs. 67.4%, P = 0.023). There were no significant differences in the rates of other complications and emergency department readmission between the GAL and SA groups.
UNASSIGNED: GAL emerges as a favorable choice for anesthesia in hemorrhoidectomy, demonstrating a lower incidence of urine retention and a prolonged analgesic effect in multiple hemorrhoidectomies. These findings support the conclusion that GAL represents an optimal anesthetic method for enhancing the postoperative experience in patients undergoing hemorrhoidectomy.