Comparison Of Open Hemorrhoidectomy Under Local Anesthesia Versus Saddle Block: A Cost-Effectiveness And Clinical Outcomes Analysis
Bibliographic record
Abstract
Background: Haemorrhoids are a common anorectal disorder requiring surgical intervention in severe cases. Open haemorrhoidectomy (OH) is a widely performed procedure, with anaesthesia choice significantly impacting patient outcomes and healthcare costs. While saddle block (SB) anaesthesia is frequently used, local anaesthesia (LA) has been proposed as a cost-effective and efficient alternative, especially in resource-limited settings. Methods: A double-blind, randomized controlled trial (RCT) was conducted to compare the clinical and economic outcomes of OH performed under LA versus SB. A total of 80 patients with 3rd or 4th-degree haemorrhoids were randomly assigned into two groups (40 per group). The study evaluated operative time, hospital stay duration, and cost-effectiveness using a bottom-up cost analysis approach. Data were analyzed using IBM SPSS Statistics, with statistical significance set at p<0.05. Results: The mean operating time was significantly shorter in the LA group compared to the SB group (p<0.001). Patients receiving LA also had reduced hospital stays (p<0.001). The total cost per patient was lower in the LA group compared to SB (p=0.04). While patients under LA reported slightly higher post-operative pain in the first few hours, there was no significant difference in overall complications between the groups. Conclusion: Local anaesthesia for open haemorrhoidectomy is a cost-effective alternative to saddle block, resulting in shorter hospital stays, reduced surgical costs, and comparable clinical outcomes. Implementing LA as a first-line anaesthetic technique in resource-limited settings could enhance surgical efficiency and reduce the financial burden on healthcare systems.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.009 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".