Comparison of Post-Operative Analgesic Requirement in Patients undergoing Hemorrhoidectomy Under Caudal Epidural Anaesthesia Versus Saddle Anaesthesia

Objective: To compare post-operative analgesic requirements in patients undergoing hemorrhoidectomy under caudal epidural anaesthesia versus saddle anaesthesia. Study Design: Quasi Experimental Study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, Feb to Nov 2021. Methodology: The study was conducted on 200 patients who underwent hemorrhoidectomy during the study period. Patients were randomized into two groups. Group-A received caudal epidural anaesthesia, while Group-B received saddle anaesthesia. The pain at the surgical site was recorded on a visual analogue scale 04 hours and 08 hours after the surgical procedure. The difference in significant post-operative pain and the requirement of opioid analgesia was compared. Results: Out of 200 patients randomized into two groups, 96(48%) were categorized into Group-A, and 104(52%) were categorized into Group-B. The mean age of patients who were operated for hemorrhoids in our study was 41.56±6.98 years. Patients who received caudal epidural anaesthesia had more chances of not having significant post-operative pain at 04 and 08 hours after the surgery as compared to those who received saddle anaesthesia (p-value<0.05). The requirement of opioid analgesia at 02 hours was also statistically significantly less in these patients as well (p-value<0.05). Conclusion: The Use of caudal epidural anaesthesia during the haemorrhoidectomy emerged as better management for early post-operative pain as compared to the use of saddle anaesthesia. The requirement for opioid analgesia was higher in patients after two hours of surgery who received saddle block than those who were administered caudal epidural anaesthesia.