Volume : 4, Issue : 12, December - 2015

Anaesthesia for ambulatory anorectal surgery

Dr Surendra Kumar Jain, Dr Sanjeev D. Jain

Abstract :

<p>&lt;p&gt;&amp;lt;p&amp;gt;The prevalence of minor anorectal diseases is 4&amp;amp;ndash;5% of adult Western population. Operations are performed on ambulatory or 24-hour stay basis. Requirements f or ambulatory anaesthesia are: rapid onset and recovery, ability to provide quick adjustments during maintenance, lack of intraoperative and postoperative side effects, and cost effectiveness. Anorectal surgery requires deep levels of anaesthesia. The aim is achieved with 1) regional blocks alone or in combination with monitored anaesthesia care or 2) deep general anaesthesia, usually with muscle relaxants and tracheal intubation. Modern general anaesthetics provide smooth, quickly adjustable anaesthesia and are a good choice for ambulatory surgery. Popular regional methods are: spinal anaesthesia, caudal blockade, posterior perineal blockade and local anaesthesia. The trend in regional anaesthesia is lowering the dose of local anaesthetic, providing selective segmental block. Adjuvants potentiating analgesia are recommended. Postoperative period may be complicated by: 1) severe pain, 2) urinary retention due to common nerve supply, and 3) surgical bleeding. Complications may lead to hospital admission. In conclusion, novel general anaesthetics are recommended for ambulatory anorectal surgery. Further studies to determine an optimal dose and method are needed in the group of regional anaesthesia.&amp;lt;/p&amp;gt;&lt;/p&gt;</p>