Lateral Anal Sphincterotomy for Chronic Anal Fissures- A Comparison of Outcomes and Complications under Local Anaesthesia Versus Spinal Anaesthesia

Objective: To compare the mean pain scores at 6 hours and 24 hours after lateral internal sphincterotomy under local anesthesia versus spinal anesthesia. Study Design: A double-blind prospective randomized controlled trial study Place and Duration of Study: This study was conducted at the conducted at surgical unit 2, Civil Hospital Karachi, Pakistan from June, 2018 to December, 2018 for a period of six months. Materials and Methods: A total of 60 patients were selected by non-probability consecutive sampling, aged 18-65 years of either gender with complaint of chronic anal fissure lasting 3 months, underwent lateral internal sphincterotomy. They were randomized into 30 patients who received local anesthesia and 30 patients who received spinal anesthesia by closed envelop method. Mean pain score was measured as the primary outcome at 6 hours and 24 hours after the procedure. Results: There was no statistically significant difference found in mean pain score at 6 hours and 24 hours after the LIS in both groups. Mean pain score at 6 hours was 5.40 (±1.886) and 5.40 (±2.568) respectively (p-value=0.102) while at 24 hours mean pain score was 1.77 (±1.278) and 2.37(±1.159) respectively (p-value=0.859). Moreover, the patients who had local anesthesia were met withlow risk of anesthesia, short hospital stay and early return to home. Conclusion: Lateral internal sphincterotomy can be safely performed under local anesthesia with minimum risk of complications.