Abstract

Background: Today there is an attempt to perform Lateral Internal Sphincterotomy (LIS) operation on an ambulatory basis under local anesthesia. This study aimed to compare postoperative outcome in local anesthesia with spinal anesthesia. Methods: Design: randomized, double blinded, controlled trial. 62 patients were randomly divided into group A (local anesthesia) and group B (spinal anesthesia) with n = 31 equally. To achieve adequate anesthesia a cocktail, 6 cc of Lidocaine 2 and Marcaine 0.5 the addition of some bicarbonate was injected into subcutaneous tissue and 20 cc of this was injected into the inter-sphincteric space before LIS. Post operative pain was assessed by a 10 cm VAS. Results: Needle pain scores in group A and B were: 2.29 ± 1.40 vs. 1.61 ± 0.88. While pain scores, 6 hours after LIS, before leaving hospital and at the first week after the operation were significantly lower in group A than B (1.90 ± 1.07 vs. 3.77 ± 1.25, 0.90 ± 0.47 vs. 1.65 ± 0.75, 0.71 ± 0.46 vs. 1.06 ± 0.51 respectively). Need of opioid and codeine in 24 hours after the operation in group A was significantly less than in the other group (28.71 ± 22.17 mg vs. 54.55 ± 22.92 mg, P < 0.05 and 10.4 ± 13.6 mg vs. 18.8 ± 17.8 mg, P = 0.04, respectively). Also nausea and vomiting in group A was significantly lower than in group B (3.2 vs. 19.4 respectively, P < 0.05). Conclusions: The study showed LIS under local anesthesia is a less painful technique on office surgery. © Springer-Verlag 2006.