Analgesic effect of local anaesthetic in haemorrhoid banding: systematic review and meta-analysis

• Published in: International journal of colorectal disease 2024-03, Vol.39 (1), p.34-34, Article 34
• Main Authors: Watson, Eleanor G. R., Ong, Hwa Ian, Shearer, Nicholas J. W., Smart, Philip J., Burgess, Adele N., Proud, David M., Mohan, Helen M.
• Format: Article
• Language: English
• Subjects: Anesthesia, Local; Anesthetics, Local; Gastroenterology; Hemorrhoids - surgery; Hepatology; Humans; Internal Medicine; Medicine; Medicine & Public Health; Pain; Pain, Procedural; Proctology; Review; Surgery
• ISSN: 1432-1262; 0179-1958; 1432-1262
• DOI: 10.1007/s00384-024-04609-8

Purpose Rubber band ligation of haemorrhoids can be,painful and there is no consensus regarding the optimal analgesic strategy. This study aims to determine whether there is a difference in post-procedural pain in adults undergoing haemorrhoid banding who have received local anaesthetic, a pudendal nerve block or no regional or local analgesia. Methods MEDLINE, Embase, Google Scholar and clinical trial registries were searched for randomised trials of local anaesthetic or pudendal nerve block use in banding. Primary outcomes were patient-reported pain scores. The quality of the evidence was assessed using the GRADE approach. Results Seven studies were included in the final review. No articles were identified that studied pudendal nerve blocks. The difference in numerical pain scores between treatment groups favoured the local anaesthetic group at all timepoints. The mean difference in scores on a 10-point scale was at 1 h,—1.43 (95% CI—2.30 to—0.56, p