Surgical treatment of anal fissures under local anesthesia

OBJECTIVE: To evaluate lateral sphincterotomy under a mixture of local anesthesia versus general anesthesia in the treatment of anal fissures.

METHODS: A randomized clinical trial of 62 consecutive patients requiring lateral sphincterotomy was carried out at Princess Haya Al-Hussein Hospital in Jordan. One group underwent lateral sphincterotomy under general anesthesia, while the 2nd group had topical anesthetic cream (xylocaine 2%) applied followed by local anesthesia.

RESULTS: There were no differences between the 2 groups in terms of operating time, postoperative pain, nausea or vomiting, pain-free interval after operation, analgesia requirements or patients satisfaction with the method of anesthesia.

CONCLUSION: Topical anesthetics and local anesthesia can be used effectively for lateral sphincterotomy and provides an alternative to general anesthesia.