Our Summary

This research paper talks about a study conducted to compare the experience of pain after a type of surgery called open hemorrhoidectomy. The surgery was performed under two different types of anesthesia: local anesthesia and saddle block. The study was done in a developing country and was specifically focused on patients with severe hemorrhoids.

58 patients participated in the study, roughly half male and half female, with an average age of 39. The researchers measured the patients’ pain levels at 2, 4, and 6 hours after the surgery.

The results showed that the type of anesthesia used didn’t significantly affect the level of pain patients felt after surgery. However, the researchers found that monitoring the patient’s pain level was particularly important 2 hours after the surgery to determine if pain relief medication was needed.

FAQs

  1. What is the difference between local anesthesia and saddle block used in an open hemorrhoidectomy?
  2. Did the type of anesthesia used during hemorrhoidectomy have a significant impact on the level of post-operative pain experienced by the patients?
  3. Why was the 2-hour mark after surgery identified as a crucial time for monitoring patient’s pain levels?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hemorrhoidectomy is to closely monitor their pain levels in the hours following the surgery, especially within the first 2 hours. If the patient experiences severe pain, they should not hesitate to contact their healthcare provider for appropriate pain relief medication. It is important to follow post-operative care instructions provided by the surgeon to ensure a smooth recovery process.

Suitable For

Patients recommended for hemorrhoidectomy are typically those with severe hemorrhoids that have not responded to conservative treatments such as dietary changes, over-the-counter medications, and lifestyle modifications. These patients may experience symptoms such as persistent pain, bleeding, itching, and prolapse of hemorrhoids.

Additionally, patients who have recurrent hemorrhoids or those with complications such as thrombosis (blood clots in the hemorrhoid), strangulation (when the blood supply to the hemorrhoid is cut off), or significant discomfort may also be candidates for hemorrhoidectomy.

It is important for patients to discuss their symptoms with a healthcare provider to determine the best course of treatment for their individual case. Hemorrhoidectomy is a surgical procedure and should only be considered after conservative treatments have been unsuccessful.

Timeline

Before the hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as pain, itching, bleeding, and swelling around the anus.
  2. Patient consults with a healthcare provider who may recommend conservative treatments such as dietary changes, topical creams, and sitz baths.
  3. If conservative treatments are ineffective, the healthcare provider may recommend a hemorrhoidectomy as a surgical option.

After the hemorrhoidectomy:

  1. Patient undergoes pre-operative preparation such as fasting, bowel preparation, and discussion of anesthesia options.
  2. Patient undergoes the hemorrhoidectomy surgery, which involves removal of the hemorrhoids through either open or minimally invasive techniques.
  3. Patient may experience pain, discomfort, and bleeding immediately after the surgery.
  4. Patient receives pain medication and instructions for post-operative care, including wound care, diet modifications, and activity restrictions.
  5. Patient is monitored for complications such as infection, excessive bleeding, or difficulty urinating.
  6. Patient attends follow-up appointments with the healthcare provider to assess healing progress and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hemorrhoidectomy may include:

  1. What is a hemorrhoidectomy and why is it necessary in my case?
  2. What are the risks and potential complications associated with hemorrhoidectomy surgery?
  3. What type of anesthesia will be used during the surgery and how will it affect my pain levels post-surgery?
  4. What is the expected recovery time after a hemorrhoidectomy?
  5. What pain management options will be available to me after the surgery?
  6. Will I need to make any lifestyle or dietary changes post-surgery to prevent future hemorrhoids?
  7. How often should I follow up with you after the surgery?
  8. Are there any specific warning signs or symptoms that I should watch out for after the surgery?
  9. What can I do to promote healing and reduce discomfort during my recovery period?
  10. Are there any alternative treatments or procedures that I should consider before undergoing a hemorrhoidectomy?

Reference

Authors: Sikakulya FK, Ssebuufu R, Okedi XF, Baluku M, Lule H, Kiyaka SM, Kyamanywa P. Journal: BMC Surg. 2023 May 12;23(1):124. doi: 10.1186/s12893-023-02030-6. PMID: 37173653