Comparative Study of Local v/s General & Regional Anaesthesia in Perianal Day Care Surgery

In the U.K. Day surgery is defined as "the admission of selected patients to hospital for a planned surgical procedure, returning home on the same day. In determining whether a procedure is suitable to be performed on a day care basis, certain criteria must be considered. The duration of the procedure should be less than 2 hrs, postoperative pain must be easily controlled and any serious or life threatening complications would have been happened regardless of keeping patient overnight. The growth of Day Care Surgery over the past decade is the result of of developments in anaesthesia and analgesia, as well as the surgery itself. Perianal disorders include Fistula in ano, Fissures, Hemorrhoids, Perianal abscess, Pilonidal sinus. Operative procedures for these diseases can be done under local anaesthesia. This procedure is simple and safe as comparison to general anaesthesia. Decrease post operative pain means early ambulation, with further decrease in post operative complications. There is growing evidence to show that the use of local anaesthesia in anorectal surgery enables these surgeries to be done as day care. The study consists of 25 cases of perianal diseases each in local and general/regional anaesthesia group. Perianal surgery performed under local anaesthesia is safe, acceptable and cost effective method. This is also useful in patients who are unfit for general anaesthesia. Almost all patients operated under local anaesthesia were fit to be discharged by the end of 24 hours in post operative period. Early return to work also helps them financially. Hence perianal surgeries under local anaesthesia are recommended as routine method of day care surgery.