HEMORRHOIDECTOMY

​

A hemorrhoidectomy is a surgical procedure used to remove hemorrhoids. Hemorrhoids are swollen blood vessels in or around the anus and rectum. While there are various non-surgical treatments that can be effective for managing hemorrhoids, a hemorrhoidectomy is typically reserved for severe or recurring cases that haven't responded to other treatments.

                                                                                                 

                                               Anesthetic Implications for Hemorrhoidectomy 

​

Anesthesia type: General, TIVA, MAC,  regional, local anesthesia

​

Airway: LMA or ETT

​​

Preoperative:

​​

• Check with the team regarding patient position such as lithotomy or prone jack-knife​

• If prone, need prone view device and protection of face and eyes 

• If prone without an advanced airway, have oral and nasal airways readily available

• The rectoperineal area is very sensitive

• Pain is common

• Surgeons normally request to limit IV fluids (500 cc IV bag with micro drip tubing)

​

Intraoperative:

​

• Duration: 30-60 minutes

• Position: Supine, lithotomy, or prone

​

Postoperative:

​

• Pain management

​

Complications:

​

• Urinary retention

• Incontinence

• Bleeding

• Stricture

• Infection

• Peripheral nerve injury from positioning

​

Sources:

​

Macksey, L. F. (2011). Surgical procedures and anesthetic implications: A handbook for nurse anesthesia practice. 

​

Jaffe, R. A. (2020). Anesthesiologist's Manual of Surgical Procedures (6th ed.). 

​

Singh-Radcliff, N. (2013). 5-Minute Anesthesia Consult.

​

​

​

​

 

​​

​​