{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T09:28:15Z","timestamp":1771061295247,"version":"3.50.1"},"reference-count":84,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2008,4,3]],"date-time":"2008-04-03T00:00:00Z","timestamp":1207180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Day-care open haemorrhoidectomy under local anaesthesia (LH) may be the most cost-effective approach to haemorrhoidectomy. This prospective randomized trial compared outcome after LH from patients' and clinical perspectives with that after day-care open haemorrhoidectomy under general anaesthesia (GH).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Forty-one patients with third-degree haemorrhoids were randomized to LH (19) or GH (22). Patient demographics were comparable. A single haemorrhoid was excised in 15 patients, and two and three haemorrhoids in 13 each. Independent nurse-led assessment and clinical evaluation were carried out for 6 months. Outcome measures were mean and expected pain scores at 30, 60 and 90 min, then daily for 10 days, and satisfaction scores at 10 days, 6 weeks and 6 months. Secondary outcomes were journey time within the day-surgery unit and overall cost.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Pain was worse following LH than GH at 90 min after surgery (P = 0\u00b7028), but pain scores on reaching home were similar. Maximum pain was experienced on day 3 after LH and on day 6 after GH. From day 1 onwards, daily pain scores were lower in the LH group, and there was a significant difference on day 8 (mean (95 per cent confidence interval) 3\u00b761 (2\u00b774 to 4\u00b748) for LH versus 5\u00b729 (4\u00b712 to 6\u00b745) for GH; P = 0\u00b7027). Mean pain over 10 days, expectation and satisfaction scores were similar in the two groups. LH had a shorter journey time and was less expensive than GH.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>LH has similar tolerance and clinical outcome to GH, and is associated with a shorter journey time and lower cost. Registration number: NCT00503269 (http:\/\/www.clinicaltrials.gov).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.6113","type":"journal-article","created":{"date-parts":[[2008,4,3]],"date-time":"2008-04-03T15:20:54Z","timestamp":1207236054000},"page":"555-563","source":"Crossref","is-referenced-by-count":35,"title":["Randomized clinical trial comparing day-care open haemorrhoidectomy under local <i>versus<\/i> general anaesthesia"],"prefix":"10.1093","volume":"95","author":[{"given":"R","family":"Kushwaha","sequence":"first","affiliation":[{"name":"Channel Day Surgery Unit, William Harvey Hospital, Ashford TN24 0LZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W","family":"Hutchings","sequence":"additional","affiliation":[{"name":"Channel Day Surgery Unit, William Harvey Hospital, Ashford TN24 0LZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Davies","sequence":"additional","affiliation":[{"name":"Channel Day Surgery Unit, William Harvey Hospital, Ashford TN24 0LZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N G","family":"Rao","sequence":"additional","affiliation":[{"name":"Channel Day Surgery Unit, William Harvey Hospital, Ashford TN24 0LZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2008,4,3]]},"reference":[{"key":"2021070911174801600_bib1","author":"Monson","year":"2007","journal-title":"Consensus statement on PPH"},{"key":"2021070911174801600_bib2","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0966-6532(00)00042-1","article-title":"The pain of haemorrhoidectomy: a prospective study","volume":"8","author":"Limb","year":"2000","journal-title":"Ambul Surg"},{"key":"2021070911174801600_bib3","first-page":"56","article-title":"Bupivacaine local injection in anorectal surgery","volume":"83","author":"Hussein","year":"1998","journal-title":"Int Surg"},{"key":"2021070911174801600_bib4","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1007\/s10350-006-0750-8","article-title":"Perianal local block for stapled anopexy","volume":"49","author":"Gerjy","year":"2006","journal-title":"Dis Colon Rectum"},{"key":"2021070911174801600_bib5","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1046\/j.1365-2044.2002.2366_2.x","article-title":"The management of pain following day-case surgery","volume":"57","author":"McHugh","year":"2002","journal-title":"Anaesthesia"},{"key":"2021070911174801600_bib6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/S0002-9610(01)00649-3","article-title":"Radical, ambulatory hemorrhoidectomy under local anesthesia","volume":"182","author":"Argov","year":"2001","journal-title":"Am J Surg"},{"key":"2021070911174801600_bib7","first-page":"935","article-title":"Outpatient haemorrhoidectomy under local anaesthesia","volume":"163","author":"Lacerda-Filho","year":"1997","journal-title":"Eur J Surg"},{"key":"2021070911174801600_bib8","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1111\/j.1365-2044.1989.tb09196.x","article-title":"Postoperative analgesia for haemorrhoidectomy. 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