bandage-green

Anal Fissure Repair / Lateral Internal Sphincterotomy

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Lithotomy, Jack-Knife, arms at side on armboards, arms extended and flexed (superman)
Time : 5-30 min (very short)
Blood Loss : Very Low (5-10 ml)
Post-op Pain : Moderate (4-6)
Maintenance Paralytic : No
Blocks : Pudendal

Anesthetic Approaches

1GLMA, Local Anesthetic
2MAC, Propofol Drip, Local Anesthetic
3Spinal
The Surgery

Exam under anesthesia - the anal canal is inspected to confirm the fissure, exclude abscess, fistula, or malignancy, and gauge sphincter tone. Positioning - lithotomy or prone jack-knife per surgeon...

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