Outcomes of Haemorrhoidectomy Performed Under Local Anaesthesia at a Tertiary Care Hospital

Abstract

Background: Haemorrhoidectomy is an established treatment for advanced symptomatic haemorrhoidal disease. Local anaesthesia may facilitate postoperative recovery and ambulatory management, although outcomes can vary according to surgical technique, anaesthetic regimen, and postoperative care.

Objective: To evaluate the clinical outcomes of haemorrhoidectomy performed under local anaesthesia, focusing on postoperative pain, complications, analgesic requirements, hospital discharge, and follow-up.

Methods: This prospective observational study included 125 adult patients undergoing haemorrhoidectomy under local anaesthesia at a tertiary-care hospital in Pakistan. Demographic, clinical, operative, anaesthetic, and postoperative data were collected using a structured proforma. Outcomes included postoperative pain, bleeding, urinary retention, wound infection, delayed wound healing, readmission, analgesic requirements, hospital stay, and follow-up completion. Data were analysed using IBM SPSS Statistics version 26. Continuous and categorical variables were summarised using appropriate descriptive statistics.

Results: Among 125 patients, 79 (63.2%) were male, and Grade III haemorrhoids were the most common presentation (60.8%). At 24 hours, moderate pain was recorded in 59 (47.2%) patients and severe pain in 18 (14.4%). Postoperative bleeding occurred in 11 (8.8%) patients, urinary retention in 9 (7.2%), wound infection in 5 (4.0%), and delayed wound healing in 8 (6.4%). Unplanned readmission occurred in 4 (3.2%) patients. Same-day discharge was achieved in 87 (69.6%) patients, while 42 (33.6%) required additional analgesia. Follow-up completion was 92.8% on postoperative day 7 and 88.8% on day 30.

Conclusion: Haemorrhoidectomy under local anaesthesia was associated with the feasibility of same-day discharge in selected patients, although postoperative pain and complications remained important considerations. Comparative studies are required to determine its relative effectiveness and safety against other anaesthetic techniques.