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Session: ePoster: Benign Anorectal 6 (Mon1015)

EP688 - Comparative Study of Safety between Perianal Nerve Block and Spinal Anesthesia for Hemorrhoidectomy

Monday, May 12, 2025
10:31 AM – 10:36 AM PT

    ePoster Presenter(s)

  • Pathompong Pruekprasert, MD (he/him/his)

    Fellow in colorectal surgery
    Vajira Hospital and Chiang University Hospital
    Khon Kaen, Khon Kaen, Thailand

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • PC

    Punnawat Chandrachamnong, MD

    Assistant professor (attending colorectal surgeon)
    Vajira Hospital
    Bangkok, Krung Thep, Thailand

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Pathompong Pruekprasert, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Hemorrhoids are a prevalent condition with various treatment options. Hemorrhoidectomy, known for its low recurrence rate, is one of the most commonly performed procedures among colorectal surgeons. The choice of anesthesia plays a critical role in postoperative outcomes. This study aims to compare two anesthesia techniques—spinal anesthesia and perianal nerve block with total intravenous anesthesia (TIVA)—in terms of postoperative urinary retention, complications, pain levels, opioid requirements, and hospital stay duration.

Methods/Interventions: This retrospective cohort study included patients with Grade II to IV hemorrhoids who underwent hemorrhoidectomy at Vajira Hospital from January 2023 to September 2024. Of the 181 patients analyzed, 132 received spinal anesthesia and 49 received perianal block with TIVA. Key outcomes measured were postoperative complications (e.g., urinary retention), pain scores at various postoperative time points, opioid consumption, and length of hospital stay.

Results/Outcomes: The overall complication rate was similar between the two groups, with 91.2% of patients experiencing no complications. Urinary retention occurred more frequently in the spinal anesthesia group (6.8%) compared to the perianal block with TIVA group (4.1%), though the difference was not statistically significant (p = 0.634). Pain scores and opioid consumption were comparable between the two groups (3.5 mg vs. 3 mg for spinal and perianal block with TIVA, respectively; p = 0.327). Median hospital stay was one day in both groups (p = 0.709).

Conclusion/Discussion: Both spinal anesthesia and perianal nerve block with TIVA provide comparable safety and efficacy for hemorrhoidectomy in terms of complications, pain management, opioid use, and hospital stay. While urinary retention was more common with spinal anesthesia, the difference was not statistically significant. Perianal block with TIVA presents itself as a viable alternative with a potential to reduce urinary retention, though further prospective studies are necessary to solidify these findings and optimize anesthesia protocols for hemorrhoidectomy.