The efficacy of anesthesia choice for lateral internal sphincterotomy: a comparison of local anesthesia and regional anesthesia

Abstract

Anal fissure is a surgical disease commonly found at outpatients department. Anal fissures are classified into acute and chronic according to the duration of symptoms and wound appearance. Most of patients diagnosed with acute anal fissure can be healed by supportive treatment, whereas the gold standard treatment for chronic fissures is lateral internal sphincterotomy (LIS). For the good result,  and patory satisfication adequate intra-operative pain control is the important factor. The aim of this study was to evaluate the efficacy of local anesthesia for lateral internal sphincterotomy. Between 2009 and 2011, 17 patients with chronic anal fissure were included in this study; 8 patients served as control group (regional anesthesia), the others were experimental group (local anesthesia). The average pain score in postoperative day 1 and 2 in the regional anesthesia group less than the local anesthesia group (P < 0.005), but the healing time and recurrent rate were not different. Perianal anesthetics infiltration provides effective intra-operative and postoperative analgesia without complications. Furthermore, perianal anesthetics infiltration has lower cost than regional anesthesia.