Anorectal surgery includes pilonidal sinus, hemorrhoidectomy, anal fissure, and anal fistula operations. General and spinal anesthesia were common anesthetic methods in anorectal surgery. We designed this study to test the hypothesis that general anesthesia was superior than spinal anesthesia with respect to urine retention rate, pain score, recovery time, and side effects.
Anorectal surgery includes pilonidal sinus, hemorrhoidectomy, anal fissure, and anal fistula operations. Deep level of anesthesia is required for these surgeries. Excellent operation conditions and rapid recovery is anticipated for optimal anesthesia. Various surgical and anesthetic techniques, including spinal anesthesia, general anesthesia and local infiltration have been used to increase the level of patients' perioperative analgesia and decrease the length of stay in the hospital. Among them, general and spinal anesthesia were common anesthetic methods in anorectal surgery. We designed this study to test the hypothesis that general anesthesia was superior than spinal anesthesia with respect to urine retention rate, pain score, recovery time, and side effects. Inclusion Criteria: * \>20 years old patients * ASA 1-2 patients * Patients who will undergo anorectal surgery with including hemorrhoidectomy, fistulectomy, fistulotomy, fissurectomy and anoplasty. Exclusion Criteria: * Having known hypersensitivity to amide type local anesthetics * Patients ASA \>=3 * Surgery methods: hemorrhoidopexy, Laser hemorrhoidoplasty * Fournier gangrene patients * Surgery due to previous complications. Characteristic data 1. Age, Gender, ASA class, 2. Past history: medical history, surgical history 3. Previous anorectal history 4. Type of anorectal surgery, number of hemorrhoidectomy 5. Methods of anesthesia, posture during surgery 6. Postoperative recovery room record: vital sign, Post Anaesthetic Discharge Scoring System (0-10, \>9 can discharge) 7. Ward record: vital sign and urine retention need foley catherization
Study Type
OBSERVATIONAL
Enrollment
1,400
The eligible patients underwent anorectal surgery under general anesthesia (GE, GM, IVG) plus locally injected analgesics.
The eligible patients underwent anorectal surgery under spinal anesthesia alone.
Taichung Verterans General Hospital
Taichung, Taiwan
Urine retention rate
urine retention events needs foley catheterization
Time frame: 0-24 hours post operation.
Pain score
Visual Analogue Scale (VAS)
Time frame: 0-24 hours post operation.
surgery complications
surgery complications
Time frame: 0-30 days post operative days.
anesthesia complications
anesthesia complications rate
Time frame: 0-30 days post operative days.
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