Local anaesthetic infiltration for the rubber band ligation of early symptomatic haemorrhoids: a systematic review and meta-analysis

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• 作者：M. S. Sajid ; M. I. Bhatti ; J. Caswell ; P. Sains ; M. K. Baig
• 关键词：Haemorrhoids ; Rectal bleeding ; Haemorrhoidectomy ; Anal pain ; Tenesmus
• 刊名：Updates in Surgery
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：67
• 期：1
• 页码：3-9
• 全文大小：1,024 KB
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• 作者单位：M. S. Sajid (1)
  M. I. Bhatti (2)
  J. Caswell (1)
  P. Sains (1)
  M. K. Baig (1)
  
  1. Department of General, Endoscopic and Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Trust, Worthing Hospital, Worthing, West Sussex, BN11 2DH, UK
  2. Department of General and Colorectal Surgery, Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust, Gayton Road, King’s Lynn, Norfolk, PE30 4ET, UK
  
• 刊物主题：Surgery;
• 出版者：Springer Milan
• ISSN：2038-3312

文摘

The objective of this article is to systematically analyse the randomized, controlled trials evaluating the effectiveness of local anaesthetic infiltration prior to the rubber band ligation of early symptomatic haemorrhoids. Published randomized, controlled trials comparing the use of local anaesthetic (LA) versus no-local anaesthetic (NLA) for the rubber band ligation of early symptomatic haemorrhoids were analysed using RevMan?, and the combined outcomes were expressed as odds ratios (OR) and standardized mean difference (SMD). Four randomized, controlled trials evaluating 387 patients were retrieved from the standard electronic databases. The risk of treatment failure (OR 0.44; 95?% CI 0.07, 2.79; z?=?0.87; p?=?0.39) and post-procedure complications (OR 0.48; 95?% CI 0.08, 2.76; z?=?0.83; p?=?0.41) was similar between two techniques. However, the post-procedure pain score (SMD ?.19; 95?% CI ?.08, ?.30; z?=?2.62; p?<?0.009) was significantly lower in the group of patients undergoing rubber band ligation of haemorrhoids under local anaesthetic injection. The use of LA appears to have clinically measurable advantages over NLA in the rubber band ligation of early symptomatic haemorrhoids to lessen post-procedure pain.