Skip to main content
Erschienen in: Updates in Surgery 1/2015

01.03.2015 | Review Article

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

verfasst von: M. S. Sajid, M. I. Bhatti, J. Caswell, P. Sains, M. K. Baig

Erschienen in: Updates in Surgery | Ausgabe 1/2015

Einloggen, um Zugang zu erhalten

Abstract

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 −5.19; 95 % CI −9.08, −1.30; 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.
Literatur
1.
Zurück zum Zitat Dal Monte PP, Tagariello C, Sarago M et al (2007) Transanal haemorrhoidal dearterialisation: nonexcisional surgery for the treatment of haemorrhoidal disease. Tech Coloproctol 11:333–338CrossRefPubMed Dal Monte PP, Tagariello C, Sarago M et al (2007) Transanal haemorrhoidal dearterialisation: nonexcisional surgery for the treatment of haemorrhoidal disease. Tech Coloproctol 11:333–338CrossRefPubMed
2.
Zurück zum Zitat Jayaraman S, Colquhoun PH, Malthaner RA (2007) Stapled hemorrhoidopexy is associated with a higher long-term recurrence rate of internal hemorrhoids compared with conventional excisional hemorrhoid surgery. Dis Colon Rectum 50:1297–1305CrossRefPubMed Jayaraman S, Colquhoun PH, Malthaner RA (2007) Stapled hemorrhoidopexy is associated with a higher long-term recurrence rate of internal hemorrhoids compared with conventional excisional hemorrhoid surgery. Dis Colon Rectum 50:1297–1305CrossRefPubMed
3.
Zurück zum Zitat Carapeti EA, Kamm MA, McDonald PJ (1998) Double-blind randomised controlled trial of effect of metronidazole on pain after day-case haemorrhoidectomy. Lancet 351:169–172CrossRefPubMed Carapeti EA, Kamm MA, McDonald PJ (1998) Double-blind randomised controlled trial of effect of metronidazole on pain after day-case haemorrhoidectomy. Lancet 351:169–172CrossRefPubMed
4.
Zurück zum Zitat Wałega P, Scheyer M, Kenig J, Herman RM (2008) Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up. Surg Endosc 22:2379–2383CrossRefPubMed Wałega P, Scheyer M, Kenig J, Herman RM (2008) Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up. Surg Endosc 22:2379–2383CrossRefPubMed
5.
Zurück zum Zitat Wrobleski DE, Corman ML, Veidenheimer MC (1980) Long-term evaluation of rubber ring ligation in hemorrhoidal disease. Dis Colon Rectum 23:478–482CrossRefPubMed Wrobleski DE, Corman ML, Veidenheimer MC (1980) Long-term evaluation of rubber ring ligation in hemorrhoidal disease. Dis Colon Rectum 23:478–482CrossRefPubMed
6.
Zurück zum Zitat MacRae HM, McLeod RS (1995) Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum 38:687–694CrossRefPubMed MacRae HM, McLeod RS (1995) Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum 38:687–694CrossRefPubMed
9.
Zurück zum Zitat Bat L, Melzer E, Koler M (1993) Complications of rubber band ligation of symptomatic internal hemorrhoids. Dis Colon Rectum 36:287–290CrossRefPubMed Bat L, Melzer E, Koler M (1993) Complications of rubber band ligation of symptomatic internal hemorrhoids. Dis Colon Rectum 36:287–290CrossRefPubMed
11.
Zurück zum Zitat Barwell J, Watkins RM, Lloyd-Davies E et al (1999) Life-threatening retroperitoneal sepsis after hemorrhois injection sclerotherapy. Report of a case. Dis Colon Rectum 42:421–423CrossRefPubMed Barwell J, Watkins RM, Lloyd-Davies E et al (1999) Life-threatening retroperitoneal sepsis after hemorrhois injection sclerotherapy. Report of a case. Dis Colon Rectum 42:421–423CrossRefPubMed
12.
Zurück zum Zitat Tchirkow G, Haas PA, Fox TA Jr (1982) Injection of a local anesthetic solution into hemorrhoidal bundles following rubber band ligation. Dis Colon Rectum 25:62–63CrossRefPubMed Tchirkow G, Haas PA, Fox TA Jr (1982) Injection of a local anesthetic solution into hemorrhoidal bundles following rubber band ligation. Dis Colon Rectum 25:62–63CrossRefPubMed
13.
Zurück zum Zitat Lee HH, Spencer RJ, Beart RW Jr (1994) Multiple haemorrhoidal bandings in a single session. Dis Colon Rectum 37:37–41CrossRefPubMed Lee HH, Spencer RJ, Beart RW Jr (1994) Multiple haemorrhoidal bandings in a single session. Dis Colon Rectum 37:37–41CrossRefPubMed
14.
Zurück zum Zitat Lau WY, Chow HP, Poon GP et al (1982) Rubber band ligation of three primary hemorrhoids in a single session-a safe and effective procedure. Dis Colon Rectum 25:336–339CrossRefPubMed Lau WY, Chow HP, Poon GP et al (1982) Rubber band ligation of three primary hemorrhoids in a single session-a safe and effective procedure. Dis Colon Rectum 25:336–339CrossRefPubMed
15.
Zurück zum Zitat Hardwick RH, Durdey P (1994) Should rubber band ligation of hemorrhoids be performed at the initial outpatient visit? Ann R Coll Surg Engl 76:185–187PubMedCentralPubMed Hardwick RH, Durdey P (1994) Should rubber band ligation of hemorrhoids be performed at the initial outpatient visit? Ann R Coll Surg Engl 76:185–187PubMedCentralPubMed
16.
Zurück zum Zitat Patel S, Shahzad G, Rizvon K et al (2014) Rectal ulcers and massive bleeding after hemorrhoidal band ligation while on aspirin. World J Clin Cases 2:86–89CrossRefPubMedCentralPubMed Patel S, Shahzad G, Rizvon K et al (2014) Rectal ulcers and massive bleeding after hemorrhoidal band ligation while on aspirin. World J Clin Cases 2:86–89CrossRefPubMedCentralPubMed
17.
Zurück zum Zitat Fox A, Tietze PH, Ramakrishnan K et al (2014) Anorectal conditions: hemorrhoids. FP Essent 419:11–19PubMed Fox A, Tietze PH, Ramakrishnan K et al (2014) Anorectal conditions: hemorrhoids. FP Essent 419:11–19PubMed
18.
Zurück zum Zitat Altomare DF, Giuratrabocchetta S (2013) Conservative and surgical treatment of haemorrhoids. Nat Rev Gastroenterol Hepatol 10:513–521CrossRefPubMed Altomare DF, Giuratrabocchetta S (2013) Conservative and surgical treatment of haemorrhoids. Nat Rev Gastroenterol Hepatol 10:513–521CrossRefPubMed
20.
Zurück zum Zitat Review Manager (RevMan) [Computer program]. Version 5.3. The Nordic Cochrane Centre, The Cochrane Collaboration: Copenhagen, 2008 Review Manager (RevMan) [Computer program]. Version 5.3. The Nordic Cochrane Centre, The Cochrane Collaboration: Copenhagen, 2008
21.
Zurück zum Zitat DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188CrossRefPubMed DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188CrossRefPubMed
22.
Zurück zum Zitat DeMets DL (1987) Methods for combining randomized clinical trials: strengths and limitations. Stat Med 6:341–350CrossRefPubMed DeMets DL (1987) Methods for combining randomized clinical trials: strengths and limitations. Stat Med 6:341–350CrossRefPubMed
23.
Zurück zum Zitat Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558CrossRefPubMed Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558CrossRefPubMed
24.
Zurück zum Zitat Egger M, Smith GD, Altman DG (2006) Systematic reviews in healthcare. BMJ Publishing, London Egger M, Smith GD, Altman DG (2006) Systematic reviews in healthcare. BMJ Publishing, London
25.
Zurück zum Zitat Deeks JJ, Altman DG, Bradburn MJ (2001) Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In: Egger M, Smith GD, Altman DG (eds) Systemic reviews in health care: meta-analysis in context, 2nd edn. BMJ Publication group, London, p 285–312 Deeks JJ, Altman DG, Bradburn MJ (2001) Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In: Egger M, Smith GD, Altman DG (eds) Systemic reviews in health care: meta-analysis in context, 2nd edn. BMJ Publication group, London, p 285–312
26.
Zurück zum Zitat Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12CrossRefPubMed Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12CrossRefPubMed
27.
Zurück zum Zitat Chalmers TC, Smith H Jr, Blackburn B et al (1981) A method for assessing the quality of a randomized control trial. Control Clin Trials 2:31–49CrossRefPubMed Chalmers TC, Smith H Jr, Blackburn B et al (1981) A method for assessing the quality of a randomized control trial. Control Clin Trials 2:31–49CrossRefPubMed
29.
Zurück zum Zitat Gokalp A, Baskonus I, Maralcan G (2003) A prospective randomised study of local anaesthetic injection after multiple rubber band ligation of haemorrhoids. Chir Ital 55:213–217PubMed Gokalp A, Baskonus I, Maralcan G (2003) A prospective randomised study of local anaesthetic injection after multiple rubber band ligation of haemorrhoids. Chir Ital 55:213–217PubMed
30.
Zurück zum Zitat Hooker GD, Plewes EA, Rajgopal C et al (1999) Local injection of bupivacaine after rubber band ligation of hemorrhoids: prospective, randomized study. Dis Colon Rectum 42:174–179CrossRefPubMed Hooker GD, Plewes EA, Rajgopal C et al (1999) Local injection of bupivacaine after rubber band ligation of hemorrhoids: prospective, randomized study. Dis Colon Rectum 42:174–179CrossRefPubMed
31.
Zurück zum Zitat Kwok HCK, Noblett SE, Murray NEA et al (2013) The use of local anaesthesia in haemorrhoidal banding: a randomized controlled trial. Colorectal Dis 15:487–491CrossRefPubMed Kwok HCK, Noblett SE, Murray NEA et al (2013) The use of local anaesthesia in haemorrhoidal banding: a randomized controlled trial. Colorectal Dis 15:487–491CrossRefPubMed
32.
Zurück zum Zitat Law WL, Chu KW (1999) Triple rubber band ligation for hemorrhoids: prospective, randomized trial of use of local anesthetic injection. Dis Colon Rectum 423:336–363 Law WL, Chu KW (1999) Triple rubber band ligation for hemorrhoids: prospective, randomized trial of use of local anesthetic injection. Dis Colon Rectum 423:336–363
Metadaten
Titel
Local anaesthetic infiltration for the rubber band ligation of early symptomatic haemorrhoids: a systematic review and meta-analysis
verfasst von
M. S. Sajid
M. I. Bhatti
J. Caswell
P. Sains
M. K. Baig
Publikationsdatum
01.03.2015
Verlag
Springer Milan
Erschienen in
Updates in Surgery / Ausgabe 1/2015
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-015-0286-3

Weitere Artikel der Ausgabe 1/2015

Updates in Surgery 1/2015 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.