The comparison of general anaesthesia using the bispectral analysis (BIS) and spinal anaesthesia in terms of the one-day health care for haemorrhoid surgery using the HAL-RAR method.

OBJECTIVES: The gradual advancement of one-day surgery and conjoint ambulatory anaesthesia results from possibilities to execute mini-invasive surgeries. Such surgeries offer great benefits to the patient due to faster reconvalescence and less pain as well as faster return to normal life. The HAL-RAR method for haemorrhoid surgery, introduced as early as in 1995 by Dr. Morigan in Japan.

DESIGN AND SETTING: The goal of our study including 137 patients was research of effects of the spinal and general anaesthesia while monitoring the Bispectral Index (BIS) during the surgery. We focused mainly on the need of postoperative analgesia and possibility to discharge patient to home care after the surgery with the above mentioned type of anaesthesia. BIS helped us to monitor the sufficiency of anaesthesia and anaesthetics dosage regulation that was reflected in earlier awakening and faster reconvalescence, as well as saving anaesthetics.

RESULTS: The length of surgery was not affected by the particular type of anaesthetic procedures (25.7 minutes for the general anaesthesia and 30.2 minutes for the spinal anaesthesia). The need for postoperative analgesia was necessary for the period of 240.0 minutes after the completion of surgery for the general anaesthesia and 313.0 minutes for the spinal anaesthesia after the administration of anaesthetics intrathecally.

CONCLUSIONS: BIS is a processed EEG parameter measuring the hypnotic effect of hypnotics and sedatives in brain. BIS helps to reduce the use of anaesthetics during anaesthesia. Our results are promising and we continue in the study, monitoring also other possible parameters.