Discussion
hemorrhoids
HEMORRHOIDS
In our cost-analysis comparison of OH under LA versus SB among patients with 3rd or 4th degree hemorrhoids at three major hospitals in rural Western Uganda, we found that the operating time was greater for SB compared to LA. This is contrary to findings of Younes et al. in Egypt [The use of local anesthesia has been shown to be impactful in terms of reducing the cost of surgery though day care surgical approach across the world [In our analysis, we found that the use of LA was significantly associated with low overall cost of OH compared to SB. Our findings are comparable to studies in England and Bangladesh respectively, in regards to shorter hospital stay and costs related to the use of LA versus SB for OH [The results of the present trial are also supported by Shaw & Ternent who documented that use of LA was associated with lower financial burden compared to other types of anesthesia for day care surgery by reducing the admission costs, minimal use of ward-based facilities plus decreased medication charges [The policy implication of these findings is that the low cost of OH under LA if adopted could protect against impoverishment from direct out-of-pocket payments for surgical and anesthesia care in LMICS. Further, this could increase the surgical volume to fulfill a minimum of 5000 procedures per 100 000 population by 2030 as per the goal of global surgery 2030 [