Title: Excision of Low Fistula in Ano under Local Anaesthesia
Authors: Dr Hitesh Bhatia, Dr Priya Bharati, Dr Samta, Dr Sandeep Bhatia
Background: More than 95% of all anorectal abscesses are caused by infections arising in the anal glands that communicate with the anal crypts. Fistula-in-ano in most of cases is a benign condition which causes a considerable agony and interferes with daily quality of life of patients. Most anorectal surgeries are routinely performed under general or regional anaesthesia, but there is a growing evidence of ambulatory day care surgeries under local anaesthesia. In the present study, all cases were done under local anaesthesia with lidocaine 2% and bupivacaine 0.5% as local anaesthetic agents.
Method: All cases underwent fistulectomy under local anaesthesia and were explained about the interpretation of visual analogue scale. None of the case suffered any lignocaine/bupivacaine toxicity or any systemic complications of anaesthesia.
Results: The average time taken for surgery including the anaesthesia infiltration time was approx 26 minutes .Visual analogue score for pain documented during operation, operative day and postoperative day 1 showed no more than 7, with an average of 3-4 during the procedure .The average duration of hospital stay was approx 2 days in most cases
Conclusion: The overall benefits of early ambulation, good tolerability and fewer anaesthesia complications makes it a safer and reliable method for treating fistula in- ano under local anaesthesia.
KEYWORDS: Fistula In-Ano, Visual analogue score, Local Anaesthesia,PONV.